| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $130K | — | $130K | 5.45% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | — | $69K | $69K | 5.26% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $19K | — | $19K | 10.27% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY W BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | — | $947 | $947 | 0.50% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $5K | $297 | $5K | 18.12% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $917 | $4K | 19.59% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 350 5TH AVE, SUITE 3700 NEW YORK, NY 10118 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $643 | $643 | 4.46% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $278 | $278 | 1.93% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | CALIFORNIA DENTAL NETWORK, INC. | $729 | — | $729 | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $393 | $1K | 20.80% |
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 | 366 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 336 | $3.7M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 456 | $211K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 456 | $189K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 369 | $27K |
| Short-term disability | AFLAC | 40 | $29K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 456 | $189K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 336 | $3.7M |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 456 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 456 | — |
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.