| 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 | AETNA LIFE INSURANCE COMPANY | — | $3K | $3K | 0.38% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $9K | $9K | 3.61% |
| VARIOUS - SEE ATTACHED3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $427 | $9K | 14.66% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $897 | $897 | 18.20% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $512 | — | $512 | 17.90% |
| SANDRA SIMS4 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $128 | — | $128 | 4.47% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $82 | — | $82 | 2.87% |
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 | 164 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 137 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $255K |
| Vision | VISION SERVICE PLAN | 148 | $36K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $255K |
| Short-term disability | AFLAC | 52 | $58K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $255K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 137 | $1.4M |
| Other(4 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.