| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 5.00% |
| ACRISURE LLC3 | 1460 US HIGHWAY 9 N SUITE 307 WOODBRIDGE, NJ 07095 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 1.44% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.97% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.38% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.97% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.51% |
| ACRISURE LLC3 | 2965 ALTERNATE 19 NORTH PALM BEACH, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $689 | $5K | 22.96% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHEAST PARTNERS INSURAN | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $689 | $689 | 2.96% |
| FRANK H FURMAN INC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $689 | $689 | 2.96% |
| JLP INTERESTS INC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $689 | $689 | 2.96% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: LASSITERWARE, LLC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $689 | $689 | 2.96% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.87% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $521 | $521 | 3.04% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.54% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $543 | $543 | 3.52% |
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 | 172 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 107 | $1.3M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 124 | $70K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 124 | $70K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $42K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.