| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA GDP ADVISORS | 770 KENMOOR AVE SE STE 300 GRAND RAPIDS, MI 49546 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.51% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $897 | $714 | $2K | 4.89% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $678 | — | $678 | 2.06% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $357 | $357 | 1.08% |
| MICHAEL SHANE DENSON3 | PO BOX 337 STANTON, TX 79782 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $28 | $5K | 18.07% |
| EAST TEXAS BUSINESS SOLUTIONS LLC3 | 641 COUNTY ROAD 2311 MINEOLA, TX 75773 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $860 | $1K | $2K | 8.84% |
| EDNEY ENTERPRISES LLC3 Filed as: EDNEY ENTEPRISES LLC | 22873 CR 3107 GLADE WATER, TX 75647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $315 | $2K | 7.91% |
| RUBEN D PEREZ3 | 6352 ALCORN AVE DALLAS, TX 75217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $295 | $8 | $303 | 1.20% |
| CAROL M PASTERNAK-RIFFE3 | 247 GRAHAM DR FORNEY, TX 75126 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $43 | $123 | 0.49% |
| MPART BENEFITS INC3 | 100 ALBRIGHT LN PROPSER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $42 | $77 | 0.31% |
| JACOB GOSCH3 | 4205 IRVIN DR MIDLAND, TX 79705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $8 | $15 | 0.06% |
| 3B VENTURE GROUP INC3 | 832 MALLARD TRAIL MURPHY, TX 75094 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $6 | $10 | 0.04% |
| LUCIANO VILLANUEVA3 | 371 E LAS COLINAS BLVD IRVING, TX 75039 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.02% |
| RYAN G YOUNG3 | 801 N NURSERY RD IRVING, TX 75061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
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 | 154 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $33K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $33K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 193 | $33K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 25 | $25K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 25 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.