| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLTRUST INSURANCE3 | 2965 ALT 19 PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $44K | $0 | $44K | 5.00% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $33K | $0 | $33K | 5.00% |
| HOME OFFICE TPA PAYS COMMISSION3 | 475 FALLBROOK BLVD LINCOLN, NE 68521 | AMERITAS LIFE INSURANCE CORP | $3K | $0 | $3K | 2.61% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | MONY LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 16.34% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | GIS BENEFITS MORRIS, IL 60450 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 5.54% |
| ACRISURE LLC3 Filed as: ACRISURE | 2965 ALT 19 PALM HARBOR, FL 34683 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $153 | $5K | 15.45% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $627 | $627 | 1.83% |
| ACRISURE LLC3 Filed as: ACRISURE | 2965 ALT 19 PALM HARBOR, FL 34683 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $146 | $5K | 15.48% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN | P.O. BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| MARK METTILLE3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $595 | $595 | 1.94% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | USABLE LIFE | $11K | $0 | $11K | 48.27% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | USABLE LIFE | $1K | $0 | $1K | 5.37% |
| ACRISURE LLC3 Filed as: ACRISURE | 2965 ALTERNATE 19 NORTH PALM HARBOR, FL 34683 | ADVANTICA | $2K | $0 | $2K | 15.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN | PO BOX 9039 AUSTIN, TX 78766 | ADVANTICA | $761 | $0 | $761 | 5.00% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | USABLE LIFE | $8K | $0 | $8K | 58.39% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | USABLE LIFE | $930 | $0 | $930 | 6.49% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | USABLE LIFE | $5K | $0 | $5K | 43.81% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | USABLE LIFE | $561 | $0 | $561 | 4.87% |
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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 78 | $1.5M |
| Dental | AMERITAS LIFE INSURANCE CORP | 134 | $98K |
| Vision | ADVANTICA | 202 | $15K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 206 | $52K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 103 | $34K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 88 | $31K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 78 | $1.5M |
| Other(4 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 206 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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.