| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITED HEALTHCARE INSURANCE COMPANY | $126K | — | $126K | 5.04% |
| LAGATTUTA & DUKE INSURANCE SERVICES3 | 2060D AVENIDA DE LOS ARBOLES #351 THOUSAND OAKS, CA 91362 | UNITED HEALTHCARE INSURANCE COMPANY | -$21 | — | -$21 | -0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT RD STE 600 LAGUNA NIGUEL, CA 92677 | UNITED HEALTHCARE SPECIALTY BENEFITS UNIMERICA LIFE INSURANCE CO | $3K | — | $3K | 9.99% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 501 | $2.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 227 | $114K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 501 | $2.5M |
| Life insurance | UNITED HEALTHCARE SPECIALTY BENEFITS UNIMERICA LIFE INSURANCE CO | 386 | $33K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 501 | $2.5M |
| Other | UNITED HEALTHCARE SPECIALTY BENEFITS UNIMERICA LIFE INSURANCE CO | 386 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.