| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | HEALTH OPTIONS, INC. | $19K | $0 | $19K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA | $2K | $890 | $3K | 7.26% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $725 | $3K | 14.05% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA | $1K | $471 | $2K | 13.85% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA | $1K | $407 | $1K | 13.98% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 N PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $200 | $0 | $200 | 2.99% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA ALLTRUST INSURANCE | — | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $360 | $0 | $360 | 6.00% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA | $315 | $125 | $440 | 13.98% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | ADVANTICA INSURANCE COMPANY | $160 | $0 | $160 | 5.99% |
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 | 90 | 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) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 74 | $625K |
| Dental | UNITED OF OMAHA | 79 | $45K |
| Vision(2 contracts, 2 carriers) | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 178 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA | 90 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $18K |
| Long-term disability | UNITED OF OMAHA | 25 | $12K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 74 | $625K |
| Other(2 contracts) | UNITED OF OMAHA | 90 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.