| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | BLUE CROSS OF CALIFORNIA | $87K | $6K | $93K | 5.37% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | — | $31K | $31K | 1.82% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $42K | — | $42K | 4.98% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $10K | $657 | $11K | 5.37% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $4K | $4K | 1.82% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | ANTHEM LIFE INSURANCE COMPANY | $831 | — | $831 | 6.40% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | ANTHEM LIFE INSURANCE COMPANY | $786 | — | $786 | 6.40% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | — | $393 | $393 | 3.20% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | ANTHEM LIFE INSURANCE COMPANY | $673 | — | $673 | 14.48% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | — | $168 | $168 | 3.62% |
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 | 146 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 210 | $2.6M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 323 | $199K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 323 | $199K |
| Life insurance(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 146 | $17K |
| Short-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 144 | $18K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 210 | $2.6M |
| Other(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 146 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.