| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $48K | $0 | $48K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 AKT 19 N PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $68K | $8K | $76K | 32.65% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 8.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $4K | $0 | $4K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | ADVANTICA INSURANCE COMPANY | $1K | $0 | $1K | 11.45% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN | P.O. BOX 9039 AUSTIN, TX 78766 | ADVANTICA INSURANCE COMPANY | $442 | $0 | $442 | 3.41% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 188 | $1.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 210 | $232K |
| Vision | ADVANTICA INSURANCE COMPANY | 255 | $13K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 210 | $232K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 210 | $232K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 210 | $232K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 188 | $960K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 210 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.