| 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 | CALIFORNIA PHYSICIANS SERVICE | $2K | $84K | $86K | 6.43% |
| AMWINS5 Filed as: LISI INC. | 1600 HILLDALE BLVD. SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $29K | $29K | 2.13% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 6.32% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $667 | $4K | 12.27% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $442 | $3K | 12.08% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $33 | $2K | 15.14% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $29 | $1K | 10.22% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $301 | $2K | 12.29% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $740 | $16 | $756 | 10.22% |
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) | CALIFORNIA PHYSICIANS SERVICE | 109 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $144K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 109 | $1.3M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $51K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 62 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $13K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 109 | $1.3M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.