| 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 FOUNDATION HEALTH PLAN INC | $164K | — | $164K | 0.70% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $60K | — | $60K | 58.32% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING CIR SUITE 116 LARKSPUR, CA 94939 | STANDARD INSURANCE COMPANY | $31K | — | $31K | 30.00% |
| USI INSURANCE SERVICES LLC3 | ATTN SAN FRANCISCO PO BOX 66119 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 11.68% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, | LLC DBA L.B.L. INSURANCE 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $300 | — | $300 | 2.64% |
| HASTINGS, BONNIE, J3 | 14931 CRYSTAL CIRCLE IRVINE, CA 92604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3 | $3 | 0.03% |
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 | 5,939 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,992 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 4,798 | $39.5M |
| Dental | AETNA LIFE INSURANCE CO. | 2,588 | $428K |
| Vision | VISION SERVICE PLAN | 4,376 | $846K |
| Life insurance | STANDARD INSURANCE COMPANY | 5,704 | $102K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,704 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.