| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DR NE STE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| ACRISURE LLC5 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DR NE STE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 1.68% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DR NE STE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DR NE STE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ACRISURE LLC3 | 3580 PIERCE DR STE 100 CHAMBLEE, GA 30341 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $548 | $2K | 21.14% |
| ACRISURE LLC3 | 3580 PIERCE DR STE 100 CHAMBLEE, GA 30341 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $906 | $269 | $1K | 21.50% |
| ACRISURE LLC3 | 3580 PIERCE DRIVE STE 100 CHAMBLEE, GA 30341 | CIGAN HEALTH AND LIFE INSURANCE COMPANY | $565 | $165 | $730 | 21.50% |
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 | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $60K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $27K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.