| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 10.51% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $412 | $412 | 0.75% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $386 | $22 | $408 | 4.48% |
| SHIRLEY B DRAKE3 Filed as: SHIRLEY B.DRAKE | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $34 | $150 | 1.65% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE AMERICA, LLC | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $24 | $148 | 1.63% |
| SHELBY GROUP INC3 | 1175 STEWART DRIVE DUNEDIN, FL 34698 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $3 | $119 | 1.31% |
| KASSANDRA MARIE WILL3 | 2315 BARLWOOD PASS CLEARWATER, FM 33763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $1 | $76 | 0.83% |
| FRANCISCO JAVIER RUIZ3 | 10011 COURTNEY PALMS BLVD TAMPA, FL 33619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $7 | $52 | 0.57% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ3 | 2022 ESTANCIA CIRCLE SUITE 6 KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.45% |
| EVERT KENT VERMEER3 | 3193 SANDY RIDGE DRIVE CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.22% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| THE MEEHAN AGENCY LLC3 | 1924 DOWN HOLLOW LANE WINDERMERE, FL 34786 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACRISURE LLC DBA ALLTRUST INSURANCE BROKER | Insurance agents and brokers Service code 22 | 2965 ALT 19 PALM HARBOR, FL 34683 | $26K |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 94 | $580K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 151 | $55K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 151 | $55K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 151 | $55K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 151 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.