| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE., SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | $58K | — | $58K | 4.06% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | BLUE CROSS OF CALIFORNIA | $19K | — | $19K | 1.37% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD., SUITE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN, INC. | $20K | — | $20K | 3.30% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $1 | $10K | 1.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORIA LLC | 3 POLARIS WAY, 4TH FLOOR ALISO VIEJO, CA 92656 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $5K | $18K | 7.17% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $388 | $4K | 1.57% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR. URBANDALE, IA 50323 | VISION SERVICE PLAN | $1K | — | $1K | 4.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3 POLARIS WAY, 4TH FLOOR ALISO VIEJO, CA 92656 | VISION SERVICE PLAN | $1K | — | $1K | 4.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | VISION SERVICE PLAN | $718 | — | $718 | 2.49% |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 175 | $2.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $245K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 253 | $1.4M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $245K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $245K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 175 | $2.1M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.