| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $21K | $0 | $21K | 3.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | HEALTH OPTIONS | $13K | $0 | $13K | 3.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 15.27% |
| MARK METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IA 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 8.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 BLDG I SUITE 100 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $633 | $3K | 25.02% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $114 | $114 | 0.90% |
| ACRISURE LLC3 Filed as: ACRISURE DBA GARCEAU INSURANCE AGEN | PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $100 | $100 | 0.79% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 59 | $711K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 99 | $81K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 99 | $81K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 93 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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."
No prospect flags tripped on this filing.