| 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 | $8K | $4K | $12K | 11.49% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $391 | $0 | $391 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE EIN 59-1031071 CLAIMS PROCESSOR | Float revenue; Direct payment from the plan; Contract Administrator; Other services; Non-monetary compensation; Named fiduciary; Participant communication; Claims processing Service code 12 | — | $183K |
| ACRISURE EIN 26-3554645 BROKER | Other commissions Service code 55 | — | $46K |
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 | 278 | 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) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 170 | $107K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 170 | $107K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 278 | $42K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 83 | $36K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 273 | $39K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE | 188 | $215K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 278 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.