| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $36K | — | $36K | 5.33% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT, STE 160 SANTA ROSA, CA 95401 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 10.62% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DB A VAN | 100 STONY POINT, STE 160 SANTA ROSA, CA 95401 | VISION SERVICE PLAN | $835 | — | $835 | 6.45% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN | $946 | $589 | $2K | 22.57% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $674K |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 151 | $43K |
| Vision | VISION SERVICE PLAN | 100 | $13K |
| Life insurance | GUARDIAN | 136 | $7K |
| Long-term disability | GUARDIAN | 136 | $7K |
| Other | GUARDIAN | 136 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.