| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | KAISER PERMANENTE | $103K | — | $103K | 3.68% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED CONCORDIA INSURANCE COMPANY | $6K | — | $6K | 4.15% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED CONCORDIA INSURANCE COMPANY | $1K | — | $1K | 0.89% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | — | $2K | 4.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFONIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $480 | — | $480 | 0.80% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.40% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 5.00% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.73% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE DALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $840 | — | $840 | 2.27% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $653 | — | $653 | 2.24% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.63% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $662 | — | $662 | 2.37% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | BLUE CROSS OF CALIFORNIA | $574 | — | $574 | 4.65% |
| BRAKKE SCHAFNITZ INSURANCE BROKERS3 | 28202 CABOT ROAD, SUITE 500 LAGUNA NIGUEL, CA 92677 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 26.64% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 E. DOUBLETREE RANCH ROAD SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $291 | — | $291 | 2.84% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $752 | — | $752 | 10.35% |
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 | 463 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 440 | $2.8M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 283 | $202K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 420 | $45K |
| Life insurance(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 463 | $75K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 75 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 463 | $51K |
| Prescription drug | KAISER PERMANENTE | 440 | $2.8M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 463 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 463 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.