| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA,LLC DBA BRAK | KE-SCHAFNITZ INSURANCE BROKERS, LLC 28202 CABOT RD., SUITE 600 LAGUNA NGIEL, CA 92677 | AETNA HEALTH, INC. | $51K | — | $51K | 5.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN | $16K | — | $16K | 10.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA,LLC DBA BRAK | KE-SCHAFNITZ INSURANCE BROKERS,LLC 28202 CABOT RD., SUITE 600 LAGUNA NIGEL, CA 92677 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 4.34% |
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 | 154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 151 | $155K |
| Vision | GUARDIAN | 151 | $155K |
| Life insurance | GUARDIAN | 151 | $155K |
| Other | GUARDIAN | 151 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.