| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | SUN LIFE ASSURANCE COMPANY OF CANADA | $32K | $0 | $32K | 6.40% |
| ACRISURE LLC3 | 2965 ALT 19 NORTH PALM HARBOR, FL 34683 | DELTA DENTAL INSURANCE COMPANY | $8K | $0 | $8K | 7.50% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $811 | $9K | 16.44% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $766 | $9K | 16.42% |
| ACRISURE LLC3 | 2965 ALT 19 NORTH PALM HARBOR, FL 34683 | ADVANTICA | $4K | $0 | $4K | 14.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $782 | $112 | $894 | 17.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMIN | Other services; Float revenue; Participant communication; Claims processing; Named fiduciary; Non-monetary compensation; Contract Administrator; Direct payment from the plan Service code 12 | — | $139K |
| ACRISURE AGENT | Insurance agents and brokers Service code 22 | 2965 ALT 19 N PALM HARBOR, FL 34683 | $9K |
| INTERFLEX PAYMENTS EIN 27-2256926 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $2K |
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 | 319 | 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) | 319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 225 | $107K |
| Vision | ADVANTICA | 286 | $25K |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 319 | $54K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 248 | $56K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $503K |
| Other(2 contracts) | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 319 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.