| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC. | 2965 ALT 19 PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $27K | $0 | $27K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC. | 2965 ALT 19 NORTH PALM HARBOR, FL 34683 | GUARDIAN | $8K | $3K | $11K | 13.53% |
| MARK S METTILLE3 | 107 CANDELIGHT LN MORRIS, IL 60450 | GUARDIAN | $6K | $0 | $6K | 8.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC. | 2965 ALT 19 PALM HARBOR, FL 34683 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $0 | $19K | 146.31% |
| BOONE-CHAPMAN BENEFIT ADMINISTRATOR3 | PO BOX 9201,BLDG 1 SUITE 100 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $655 | $655 | 5.00% |
| GIS BENEFITS INC3 | 9500 KOGER AVE, STE 200 ST PETERSBURG, FL 33702 | METROPOLITAN LIFE INSURANCE COMPANY | $655 | $0 | $655 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC. | 2965 ALT 19 PALM HARBOR, FL 34683 | RELIANCE STANDARD | $855 | $0 | $855 | 10.00% |
| BOONE-CHAPMAN BENEFIT ADMINISTRATOR3 | PO BOX 9201,BLDG 1 SUITE 100 AUSTIN, TX 78766 | RELIANCE STANDARD | $0 | $428 | $428 | 5.01% |
| GIS BENEFITS INC3 Filed as: GIS OF FLORIDA | 9500 KOGER AVE, STE 200 ST PETERSBURG, FL 33702 | RELIANCE STANDARD | $428 | $0 | $428 | 5.01% |
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 | 65 | 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) | 66 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 76 | $908K |
| Dental | GUARDIAN | 110 | $79K |
| Vision | GUARDIAN | 110 | $79K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 100 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.