| 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. | $21K | $0 | $21K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE | 9500 S DADELAND BLVD MIAMI, FL 33156 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 7.04% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $124 | $0 | $124 | 0.26% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 N PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $1K | $0 | $1K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | USABLE LIFE | $4K | $0 | $4K | 13.69% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $1K | $0 | $1K | 4.90% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | USABLE LIFE | $2K | $0 | $2K | 13.65% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $764 | $0 | $764 | 4.90% |
| POWERS RANDOLPH T3 | PO BOX 101088 CAPE CORAL, FL 33910 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 30.90% |
| BOTELLO MICHAEL D3 | 310 TRUMAN AVENUE LEHIGH ACRES, FL 33936 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $83 | $0 | $83 | 0.73% |
| WORKPLACE EMPLOYEE BNFT SVCS3 | 1240 W MARKET STREET LIMA, OH 45802 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | $0 | $76 | 0.67% |
| MCGUCKIN DAVID3 | 622 CENTER STREET HURON, OH 44839 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.04% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA ALLTRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $119 | $0 | $119 | 1.30% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | USABLE LIFE | $798 | $0 | $798 | 9.21% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $424 | $0 | $424 | 4.89% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA ALLTRUST INSURANCE | 2965 ALT 19 N PALM HARBOR, FL 34683 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $483 | $0 | $483 | 6.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | USABLE LIFE | $253 | $0 | $253 | 9.12% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $136 | $0 | $136 | 4.90% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | USABLE LIFE | $74 | $0 | $74 | 9.19% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $39 | $0 | $39 | 4.84% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 96 | $735K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $47K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 226 | $8K |
| Life insurance(3 contracts, 2 carriers) | USABLE LIFE | 140 | $3K |
| Short-term disability(2 contracts, 2 carriers) | USABLE LIFE | 47 | $26K |
| Long-term disability(2 contracts, 2 carriers) | USABLE LIFE | 44 | $16K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 96 | $735K |
| Other(7 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 140 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.