| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $208 | $4K | 15.87% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 26.92% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $918 | $3K | 14.70% |
| TRACY L REEVES3 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | AFLAC | $2K | $8 | $2K | 13.19% |
| MICHAEL K PORTER3 | 4000 HOLLYWOOD BLVD STE 555S HOLLYWOOD, FL 33021 | AFLAC | $450 | $2 | $452 | 2.90% |
| BRIAN GEORGE JAEGGI3 | 2875 NW 28TH ST BOCA RATON, FL 33434 | AFLAC | $249 | $2 | $251 | 1.61% |
| LEE P COHEN3 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | AFLAC | $184 | — | $184 | 1.18% |
| MARCO A ERAZO3 | 4160 SW 152ND AVE MIRAMAR, FL 33027 | AFLAC | $78 | — | $78 | 0.50% |
| KCI FINANCIAL SERV. INC3 Filed as: KCI FINANCIAL SERV INC | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | AFLAC | $62 | — | $62 | 0.40% |
| JAMES SMITH3 Filed as: JAMES B SMITH | 615 ELINOR ST CHATTANOOGA, TN 37405 | AFLAC | $28 | — | $28 | 0.18% |
| LUZ ELENA SERVI3 | 6127 S RAINBOW BLVD STE 110 LAS VEGAS, NV 89118 | AFLAC | $28 | — | $28 | 0.18% |
| LISETTE M HERNANDEZ3 | 8724 SW 72ND ST 212 MIAMI, FL 33173 | AFLAC | $25 | — | $25 | 0.16% |
| STEVE D SERVI3 | 6127 S RAINBOW BLVD STE 110 LAW VEGAS, NV 89118 | AFLAC | $20 | — | $20 | 0.13% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DR BOCA RATON, FL 33433 | AFLAC | $13 | — | $13 | 0.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JAMES GRAYDON BROWN | 2522 OWENS LANDING TRL NW KENNESAW, GA 30152 | AFLAC | $12 | — | $12 | 0.08% |
| JILL HALVERSON3 Filed as: JILL ANNE HALVERSON | 15 OXFORD ST PUEBLO, CO 81005 | AFLAC | $10 | — | $10 | 0.06% |
| MICHELLE LAMPERT3 Filed as: MICHELLE T DUBE | 104 WISCONSIN ST LAKE WORTH, FL 33461 | AFLAC | $10 | — | $10 | 0.06% |
| DAVID S MORRIS3 | 950 PENINSULA CORPORATE CIR STE 1005 BOCA RATON, FL 33487 | AFLAC | $9 | — | $9 | 0.06% |
| MARIA ORBE3 | 8362 PINES BLVD STE 250 PEMBROKE PINES, FL 33024 | AFLAC | $4 | — | $4 | 0.03% |
| FRANCO CALVO3 | 2500 PARKVIEW DR APT 1815 HALLANDALE BEACH, FL 33009 | AFLAC | $3 | — | $3 | 0.02% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $1 | — | $1 | 0.01% |
| CHRISTOPHER C HAYWARD3 | 4921 BONSAI CIR APT 211 PALM BEACH GARDENS, FL 33418 | AFLAC | $1 | — | $1 | 0.01% |
| ALLTRUST INSURANCE3 | 5411 SKYCENTER DRIVE STE 600 TAMPA, FL 33607 | TRANSAMERICA INSURANCE CO. | $1K | — | $1K | 14.38% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA INSURANCE EXCHANGE | PO BOX 1788 GRAND RAPIDS, MI 49501 | TRANSAMERICA INSURANCE CO. | $119 | — | $119 | 1.30% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $699 | $399 | $1K | 15.72% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $983 | $119 | $1K | 16.82% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $851 | $100 | $951 | 16.76% |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE CO. | 21 | $9K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $24K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 64 | $6K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $26K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18 | $22K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.