| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: NEWFRONT INSURANCE | 55 2ND STREET, FLOOR 18 SAN FRANCISCO, CA 94105 | CYPRESS DENTAL ADMINISTRATORS | $583 | $0 | $583 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3110 E GUASTI ROAD SUITE 500 ONTARIO, CA 917611228 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $149 | $0 | $149 | 16.28% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3110 E GUASTI ROAD SUITE 500 ONTARIO, CA 917611228 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $107 | $0 | $107 | 14.36% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3110 E GUASTI RD SUITE 500 ONTARIO, CA 91761 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $43 | $0 | $43 | 9.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3110 E GUASTI ROAD SUITE 500 ONTARIO, CA 917611228 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31 | $0 | $31 | 9.97% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 0 | $0 |
| Dental | CYPRESS DENTAL ADMINISTRATORS | 110 | $6K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 69 | $1K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $2K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.