| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 7.67% |
| J ROLFE DAVIS IN3 | 850 CONCOURSE PKWY S SUITE 200 MAITLAND, FL 32794 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $84 | $0 | $84 | 0.07% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DR CALEDONIA, MI 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.09% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 5.41% |
| THE BENEFIT COMPANY INC5 Filed as: THE BENEFIT COMPANY, INC | P.O. BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.95% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $700 | $1K | $2K | 5.36% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY | P.O. BOX 211486 COLUMBIA, SC 29221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.00% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.49% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $482 | $1K | $2K | 6.17% |
| THE BENEFIT COMPANY INC5 | PO BOX 211486 COLUMBIA, SC 292216486 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $957 | $957 | 3.00% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 16.40% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 8.02% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $335 | $2K | 24.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE EIN 59-1031071 CLAIMS PROCESSOR | Non-monetary compensation; Float revenue; Participant communication; Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Other services Service code 12 | — | $103K |
| ACRISURE EIN 26-3554645 BROKER | Other commissions Service code 55 | — | $38K |
| SHDR FSA ADMIN | Contract Administrator; Claims processing Service code 12 | THREE INDEPENDENCE POINTE SUITE 202 GREENVILLE, SC 29606 | $5K |
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 | 524 | 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) | 524 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 285 | $116K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 285 | $116K |
| Life insurance(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 524 | $182K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $28K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 525 | $172K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE | 270 | $220K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 524 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 525 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.