| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 10.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 2.54% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.41% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.39% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.35% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.32% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $897 | $897 | 5.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $143K |
| ACRISURE LLC EIN 26-3554645 BROKER | Other commissions Service code 55 | — | $89K |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $160K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $23K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $55K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $49K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 130 | $289K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.