| 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 | $30K | $0 | $30K | 8.17% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $0 | $17K | 4.53% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.43% |
| 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. | $2K | $0 | $2K | 6.08% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 14.77% |
| REBECCA STERNBERG3 | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.38% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.25% |
| DAVID TODD WEINSTEIN3 | 7862 WEST IRLO BRONSON MEMORIAL HWY KISSIMMEE, FL 34747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.08% |
| SANTIAGO OCHOA3 | 3605 SOUTH LOMBARD AVENUE CICERO, IL 60804 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.06% |
| ROSALINDA BENTANCUR RODRIGUEZ3 | 2035 ALTA VISTA STREET HOUSTON, TX 77023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.06% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $856 | $0 | $856 | 15.00% |
| REBECCA STERNBERG3 | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.42% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.26% |
| DAVID TODD WEINSTEIN3 | 7862 WEST IRLO BRONSON MEMORIAL HWY KISSIMMEE, FL 34747 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.09% |
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 | 698 | $369K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 423 | $31K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 698 | $388K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 698 | $369K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 698 | $369K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 698 | $388K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 698 | — |
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.