| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA | ASHTON BENEFITS 600 SYLVAN AVE., STE. 301 ENGLEWOOD CLIFFS, NJ 07632 | OXFORD HEALTH INSURANCE, INC | $22K | $776 | $23K | 4.92% |
| ACRISURE LLC3 | 600 SYLVAN AVE SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | GUARDIAN | $5K | $4K | $9K | 11.68% |
| BENJAMIN MEHAFFEY3 | 380 OLD OVEY ROAD NE ATLANTA, GA 30392 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $8K | $20K | 31.24% |
| THE WORKSIGHT GROUP LLC3 | 449 CENTRAL AVE SAINT PETERSBURG, FL 33701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $4K | $8K | 13.12% |
| ACRISURE LLC3 | 600 SYLVAN AVE ENGLEWOOD CLIFFS, NJ 07632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $22 | $5K | 7.28% |
| YOLANDO TRISTANCHO-HELWIG3 | 315 WEST 39TH STREET NEW YORK, NY 10018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $573 | $2K | $3K | 4.69% |
| L H FINANCIAL SERVICES INC3 Filed as: LH FINANCIAL SERVICES INC | 6695 HIDDEN BROOK TRL COLLEGE PARK, GA 30349 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $82 | $1K | 2.02% |
| JUSTIN RAICES BERKEY3 | 3550 WOFFORD DRIVE CUMMING, GA 30028 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $830 | $109 | $939 | 1.47% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | $159 | $467 | 0.73% |
| ELIZABETH HERNANDEZ3 | 245 W 72ND STREET NEW YORK, NY 10023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $310 | — | $310 | 0.49% |
| RJK & ASSOCIATES INC3 | 1800 PEACHTREE STREET NW ATLANTA, GA 30309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | $165 | $256 | 0.40% |
| CDC CONSULTING SERVICES INC3 | 47 WESTERN AVE DEER PARK, NY 11729 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $192 | — | $192 | 0.30% |
| SANTE CONCEPTS INC3 | 94 BARTLETT WAY DALLAS, GA 30157 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | $10 | $101 | 0.16% |
| RAUL CAIRO3 | 2555 COLLINS AVE MIAMI BEACH, FL 33140 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $96 | — | $96 | 0.15% |
| CARLA C ORTIZ ARROYO3 | 28 OXFORD PL STATEN ISLAND, NY 10301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.10% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA ASHTON BENEFITS | 600 SYLVAN AVE., STE. 301 ENGLEWOOD CLIFFS, NJ 07632 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $102 | $2K | 10.79% |
| GA SOLUTIONS LLC3 | 50 BROADWAY STE 2 HAWTHORNE, NY 10532 | PRINCIPAL LIFE INSURANCE COMPANY | $899 | $249 | $1K | 5.86% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | PRINCIPAL LIFE INSURANCE COMPANY | — | $61 | $61 | 0.31% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | OXFORD HEALTH INSURANCE, INC | 114 | $476K |
| Dental | GUARDIAN | 101 | $77K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 80 | $20K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 80 | $20K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 148 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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.