| 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 | $43K | $3K | $46K | 4.67% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $8K | $11K | 12.68% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $4K | — | $4K | 9.46% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $782 | — | $782 | 7.17% |
| 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 | $384 | $25 | $409 | 4.67% |
| SALLIE HASSON4 | PO BOX 5262 SAN PEDRO, CA 90733 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $2K | — | $2K | 21.94% |
| TETHYS INSTERNATIONAL LLC4 | 3322 DOMINCA COURT PUNTA GORDA, FL 33950 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $171 | — | $171 | 2.40% |
| CHARLES J TAYLOR4 | 24476 TOLEDO LANE LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $35 | — | $35 | 0.49% |
| MARTIN BALL4 | 839 S BEACON STREET, UNIT 5253 SAN PEDRO, CA 90733 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $28 | — | $28 | 0.39% |
| ACRISURE LLC4 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $23 | — | $23 | 0.32% |
| CARRIE WITTMAN4 | 25652 RIMGATE DRIVE, UNIT 2D LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $11 | — | $11 | 0.15% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $935 | — | $935 | 15.00% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 104 | $976K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $90K |
| Vision | VISION SERVICE PLAN | 79 | $11K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 123 | $46K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 115 | $37K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 6 | $6K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 104 | $976K |
| Other(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 123 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.