| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN, INC. | $70K | — | $70K | 4.31% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | — | $47K | $47K | 4.88% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $19K | $19K | 1.93% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $27K | — | $27K | 10.34% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | METROPOLITAN GENERAL INSURANCE COMPANY | $648 | $29 | $677 | 15.67% |
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 | 222 | 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) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 210 | $2.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $257K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $257K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $257K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $257K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $257K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 210 | $2.6M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $262K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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."
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.