| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 8430 ENTERPRISE CIRCLE SUITE 110 LAKEWOOD RANCH, FL 34202 | HEALTH OPTIONS, INC. | $21K | $0 | $21K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 8430 ENTERPRISE CIRCLE SUITE 110 LAKEWOOD RANCH, FL 34202 | BLUE CROSS BLUE SHIELD OF FLORIDA | $16K | $0 | $16K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $3K | $16K | 16.27% |
| ENROLLEASE3 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.05% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.65% |
| SAMUEL R MORRIS JR3 | 1776 AHL DRIVE JACKSONVILLE, FL 32224 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $566 | $0 | $566 | 3.70% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.24% |
| LEE BELANGER3 | 1181 HANOVER STREET SUITE 1 MANCHESTER, NH 03104 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 54.48% |
| PHILIP KELAHAN3 | 1193 HOOKSETT RD HOOKSETT, NH 03106 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $421 | $0 | $421 | 6.80% |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 41 | $747K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $101K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $101K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $107K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $101K |
| Other(4 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.