| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $22K | $0 | $22K | 6.98% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $0 | $14K | 4.34% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.03% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 8.98% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 14.90% |
| JOHNSON SCHAFF3 | 2124 WASHINGTON AVENUE WILMETTE, IL 60091 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $121 | $0 | $121 | 0.75% |
| REBECCA STERNBERG3 Filed as: REBECCA STEMBERG | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.39% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.25% |
| DAVID TODD WEINSTEIN3 | 7862 WEST IRLO BRONSON MEMORIAL HWY KISSIMMEE, FL 34747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.25% |
| SANTIAGO OCHOA3 | 2120 EL PASEO, UNIT 308 HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.13% |
| ERNESTO ELOY GARCIA3 Filed as: ERNESTO ELOY GARCIA & OTHER AGENTS | 5931 REIGER AVENUE DALLAS, TX 75214 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.12% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $933 | $0 | $933 | 16.21% |
| JOHNSON SCHAFF3 | 2124 WASHINGTON AVENUE WILMETTE, IL 60091 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.76% |
| REBECCA STERNBERG3 Filed as: REBECCA STEMBERG | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.45% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.28% |
| DAVID TODD WEINSTEIN3 | 7862 WEST IRLO BRONSON MEMORIAL HWY KISSIMMEE, FL 34747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.28% |
| JCASTELLANOS AND ASSOCIATES INC3 Filed as: JCASTELLANOS AND ASSOCIATES, INC. | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.17% |
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 | 438 | 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) | 438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 715 | $319K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 476 | $37K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 715 | $341K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 715 | $319K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 715 | $319K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 715 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 715 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.