| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE SHIELD OF CALIFORNIA | $101K | — | $101K | 5.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 28202 CABOT RD STE 600 LAGUNA NIGUEL, CA 92677 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $995 | — | $995 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 28202 CABOT RD STE 600 LAGUNA NIGUEL, CA 92677 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $298 | — | $298 | 10.00% |
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 | 246 | 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) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 404 | $2.0M |
| Dental | BLUE SHIELD OF CALIFORNIA | 404 | $2.0M |
| Vision | BLUE SHIELD OF CALIFORNIA | 404 | $2.0M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 462 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 227 | $30K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 404 | $2.0M |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 462 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 462 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.