| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | KAISER FOUNDATION HEALTH PLAN INC. | $158K | — | $158K | 4.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | UNITED CONCORDIA INSURANCE COMPANY | $11K | — | $11K | 5.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DRIVE SAN DIEGO, CA 92127 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $615 | $8K | 10.85% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $3K | — | $3K | 4.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DRIVE SAN DIEGO, CA 92127 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $487 | $6K | 10.93% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DRIVE SAN DIEGO, CA 92127 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $452 | $5K | 10.94% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DRIVE SAN DIEGO, CA 92127 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $281 | $4K | 10.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | TRANSAMERICA LIFE INSURANCE COMPANY | $114 | — | $114 | 3.99% |
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 | 617 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 626 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 492 | $3.9M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 278 | $265K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 501 | $54K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 615 | $85K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 77 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 615 | $72K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 492 | $3.9M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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.