| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2150 S CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 75070 | RELIASTAR LIFE INSURANCE COMPANY | $141K | — | $141K | 34.41% |
| ACRISURE LLC3 | 2150 S CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 75070 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $27K | $3K | $30K | 13.03% |
| ACRISURE LLC3 | 2150 S CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 75070 | VISION SERVICE PLAN | $2K | — | $2K | 4.27% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS LTD. | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | VISION SERVICE PLAN | $752 | — | $752 | 2.05% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA GDP ADVISORS, LLC | 2150 S CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 75070 | BEAZLEY INSURANCE COMPANY, INC. | $2K | — | $2K | 13.14% |
| MITCH BESVINICK3 | 1280 BRIGHTON WAY NEWTOWN SQUARE, PA 19073 | BEAZLEY INSURANCE COMPANY, INC. | $613 | — | $613 | 4.98% |
| ACRISURE LLC3 | 14 E WELSH ROAD EXTON, PA 19604 | BEAZLEY INSURANCE COMPANY, INC. | $225 | — | $225 | 1.83% |
| ACRISURE LLC3 | 2150 S CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 750704071 | UNITEDHEALTHCARE INSURANCE COMPANY | $861 | — | $861 | 10.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE LOOMIS COMPANY CLAIMS PROCESSING | Claims processing Service code 12 | 850 N. PARK ROAD WYOMISSING, PA 19610 | $212K |
| MERITAIN EIN 16-1264154 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $185K |
| GDP ADVISORS LLC EIN 46-3749464 BROKER | Insurance agents and brokers Service code 22 | — | $169K |
| FIRST HEALTH GROUP CORPORATION EIN 73-1590333 CLAIMS PROCESSING | Claims processing Service code 12 | — | $94K |
| MGU UNDERWRITING EIN 26-6943343 CLAIMS PROCESSING | Claims processing Service code 12 | — | $81K |
| HOURGLASS SYSTEMS INC. EIN 77-0495942 CLAIMS PROCESSING | Claims processing Service code 12 | — | $35K |
| TELADOC EIN 04-3705970 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $30K |
| NEW BENEFITS LTD CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 14240 PROTON ROAD DALLAS, TX 75244 | $481 |
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 | 923 | 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) | 923 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BEAZLEY INSURANCE COMPANY, INC. | 66 | $20K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $226K |
| Vision | VISION SERVICE PLAN | 136 | $37K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $226K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $226K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 207 | $226K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 171 | $722K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,964 | $635K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,964 | — |
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.