| 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 | KAISER FOUNDATION HEALTH PLAN INC. | $98K | — | $98K | 5.24% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | — | $49K | $49K | 5.26% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $20K | — | $20K | 10.16% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | — | $4K | 13.62% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | CALIFORNIA DENTAL NETWORK, INC. | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $619 | $2K | 21.74% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $953 | $282 | $1K | 19.43% |
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 | 333 | 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) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 303 | $2.8M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 294 | $219K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 294 | $202K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 333 | $16K |
| Short-term disability | AFLAC | 40 | $30K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 294 | $202K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 303 | $2.8M |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 333 | $248K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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.