| 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 | $237K | $68 | $237K | 3.86% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CALIFORNIA PHYSICIANS SERVICE | $70K | $118 | $71K | 1.15% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $64K | $4K | $69K | 7.12% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $29K | — | $29K | 3.04% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $25K | $6 | $25K | 2.75% |
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 1.56% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | $2 | $6K | 2.70% |
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 1.84% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL LIFE - SEE ATTACHMENT | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40K | $12K | $52K | 32.21% |
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 | 807 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 722 | $7.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 970 | $962K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 970 | $962K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 970 | $1.1M |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 117 | $161K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 970 | $962K |
| Prescription drug(4 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 722 | $7.3M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 970 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 970 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.