| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT ROAD, SUITE 600 LAGUNA NIGUEL, CA 92677 | AETNA HEALTH, INC. | $36K | — | $36K | 4.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT ROAD, SUITE 600 LAGUNA NIGUEL, CA 92677 | AETNA LIFE INSURANCE COMPANY | $15K | — | $15K | 6.81% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 SPECTRUM CENTER DRIVE IRVINE, CA 92618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $777 | $5K | 12.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 SPECTRUM CENTER DRIVE IRVINE, CA 92618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $442 | $4K | 16.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 SPECTRUM CENTER DRIVE IRVINE, CA 92618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $358 | $2K | 12.01% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 171 | $949K |
| Dental | AETNA LIFE INSURANCE COMPANY | 171 | $220K |
| Vision | AETNA LIFE INSURANCE COMPANY | 171 | $220K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $57K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 50 | $23K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 171 | $949K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.