| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA HEALTH OF CALIFORNIA INC. | $25K | — | $25K | 3.20% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | AETNA HEALTH OF CALIFORNIA INC. | $16K | — | $16K | 2.10% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 3.43% |
| COMPREHENSIVE FINANCIAL & INSURANCE3 Filed as: COMPREHENSIVE FINANCIAL & INS SVCS | 151 N. KRAEMER BOULEVARD, SUITE 206 PLACENTIA, CA 92870 | AMERICAN FIDELITY ASSURANCE COMPANY | $258 | — | $258 | 0.14% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $6K | — | $6K | 2.99% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | AETNA LIFE INSURANCE CO. | $4K | — | $4K | 2.30% |
| ACRISURE LLC3 Filed as: SULLIVAN & CURTIS INSURANCE BROKERS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.34% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $946 | — | $946 | 1.50% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $541 | — | $541 | 6.31% |
| ENROLLEASE3 Filed as: ONE DIGITAL - WALNUT CREEK, CA | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $301 | — | $301 | 3.51% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA DENTAL NETWORK, INC. | $689 | — | $689 | 10.01% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 156 | $1.2M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $70K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 131 | $9K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $63K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 73 | $187K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 73 | $187K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 156 | $963K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 73 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.