| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $95K | — | $95K | 3.31% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $47K | — | $47K | 1.63% |
| PROCO INSURANCE SERVICES3 Filed as: PROCO INSURANCE SERVICE | 910 E HAMILTON SUITE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $18K | — | $18K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 11.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 HAMILTON AVE STE 410 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $2K | — | $2K | 4.15% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $654 | $6K | 17.00% |
| PROCO INSURANCE SERVICES3 | 910 E HAMILTON AVE, SUITE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $38 | $3K | 11.94% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $831 | — | $831 | 3.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $79 | $2K | 15.50% |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 360 | $2.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 277 | $207K |
| Vision | VISION SERVICE PLAN | 218 | $38K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $103K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $26K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $70K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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.