| 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 | BLUE CROSS OF CALIFORNIA | $63K | — | $63K | 3.57% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 3.38% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $9K | — | $9K | 10.96% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $1K | — | $1K | 5.45% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $630 | — | $630 | 3.57% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| SALLIE HASSON4 | PO BOX 5262 SAN PEDRO, CA 90733 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | — | $1K | 18.60% |
| TETHYS INSTERNATIONAL LLC4 | 3322 DOMINCA COURT PUNTA GORDA, FL 33950 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $202 | — | $202 | 3.02% |
| CHARLES J TAYLOR4 | 24476 TOLEDO LANE LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $42 | — | $42 | 0.63% |
| MARTIN BALL4 | 839 S BEACON STREET, UNIT 5253 SAN PEDRO, CA 90733 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $33 | — | $33 | 0.49% |
| CARRIE WITTMAN4 | 25652 RIMGATE DRIVE, UNIT 2D LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $13 | — | $13 | 0.19% |
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 | 258 | 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) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 232 | $1.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $218K |
| Vision | VISION SERVICE PLAN | 156 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 259 | $97K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 243 | $80K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 10 | $11K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 232 | $1.8M |
| Other(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 259 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.