| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3631 S. HARBOR BLVD., STE 200 SANTA ANA, CA 92704 | KAISER FOUNDATIONAL HEALTH PLAN INC | $160K | — | $160K | 0.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $62K | — | $62K | 2.21% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING CIR SUITE 116 LARKSPUR, CA 94939 | STANDARD INSURANCE COMPANY | $26K | — | $26K | 0.95% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $44K | — | $44K | 2.17% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING CIR SUITE 116 LARKSPUR, CA 94939 | STANDARD INSURANCE COMPANY | $19K | — | $19K | 0.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $24K | — | $24K | 2.17% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING CIR SUITE 116 LARKSPUR, CA 94939 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 0.93% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | LBL INSURANCE 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $366 | — | $366 | 3.52% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | LBL INSURANCE SERVICES LLC 3631 S HARBOR BLVD., SUITE 200 SANTA ANA, CA 92704 | AETNA INTERNATIONAL | $187 | — | $187 | 7.50% |
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 | 5,423 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATIONAL HEALTH PLAN INC | 4,489 | $39.6M |
| Dental | AETNA LIFE INSURANCE CO. | 2,685 | $401K |
| Vision | VISION SERVICE PLAN | 4,044 | $691K |
| Life insurance | STANDARD INSURANCE COMPANY | 5,413 | $2.8M |
| Short-term disability | STANDARD INSURANCE COMPANY | 5,418 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 5,423 | $2.0M |
| Other(2 contracts, 2 carriers) | HEALTH AND HUMAN RESOURCE CENTER | 5,929 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,929 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.