| 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 | ANTHEM LIFE AND HEALTH INSURANCE CONPPANY | $143K | $5K | $147K | 90.59% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 10.00% |
| J.C.M. INDUSTRIES5 | 15302 PIPELINE LN HUNTINGTON BEACH, CA 92649 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 7.37% |
| COMPSYCH3 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.66% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $56 | $56 | 0.04% |
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM LIFE AND HEALTH INSURANCE CONPPANY | 417 | $163K |
| Dental | ANTHEM LIFE AND HEALTH INSURANCE CONPPANY | 417 | $163K |
| Vision | ANTHEM LIFE AND HEALTH INSURANCE CONPPANY | 417 | $163K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 348 | $157K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 348 | $157K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 348 | $157K |
| Prescription drug | ANTHEM LIFE AND HEALTH INSURANCE CONPPANY | 417 | $163K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 348 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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.