| 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 | $58K | — | $58K | 5.00% |
| 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 | $5K | $9K | 9.10% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 10.48% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $824 | — | $824 | 6.82% |
| 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 | $541 | — | $541 | 5.00% |
| ACRISURE LLC4 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $639 | — | $639 | 7.67% |
| JERRY HASSON4 | 850 E OCEAN BLVD, UNIT 908 LONG BEACH, CA 90802 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $463 | — | $463 | 5.56% |
| DAWN FLEMING4 | 411 WALNUT ST, #12549 GREEN CV SPRINGS, FL 32043 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $187 | — | $187 | 2.25% |
| CHARLES J TAYLOR4 | 24476 TOLEDO LANE LAKE FOREST, CA 92630 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $38 | — | $38 | 0.46% |
| MARTIN BALL4 | 839 S BEACON STREET, UNIT 5253 SAN PEDRO, CA 90733 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $31 | — | $31 | 0.37% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 111 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 120 | $96K |
| Vision | VISION SERVICE PLAN | 91 | $12K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 129 | $61K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $50K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $50K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 111 | $1.2M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 129 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.