| 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 | $11K | $7K | $18K | 12.33% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| THE BENEFIT COMPANY INC5 | PO 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 | $7K | $1K | $9K | 23.22% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.12% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.62% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | METLIFE LEGAL PLANS OF FLORIDA | $374 | $264 | $638 | 15.58% |
| EMPLOYEE BENEFIT SERVICES3 | 489 SEMINOLE ROAD MUSKEGON, MA 49444 | METLIFE LEGAL PLANS OF FLORIDA | $0 | $19 | $19 | 0.46% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $402 | $402 | 158.27% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DR CALEDONIA, MI 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 978.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE EIN 59-1031071 CLAIMS PROCESSOR | Direct payment from the plan; Named fiduciary; Claims processing; Other services; Participant communication; Float revenue; Non-monetary compensation; Contract Administrator Service code 12 | — | $195K |
| ACRISURE EIN 26-3554645 BROKER | Other commissions Service code 55 | — | $65K |
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 | 419 | 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) | 419 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 279 | $143K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 279 | $143K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 419 | $61K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $37K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 392 | $62K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE | 254 | $287K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 419 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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.