| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE | 2001 MARCUS AVE LAKE SUCCESS, NY 11042 | SUN LIFE ASSURANCE COMPANY OF CANADA | $59K | $13K | $72K | 14.12% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $38K | $12K | $50K | 11.47% |
| ACRISURE LLC3 Filed as: ACRISURE | 2965 ALT 19 N PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 12.50% |
| ACRISURE LLC3 Filed as: ACRISURE | 2965 ALT 19 PALM HARBOR, FL 34683 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18 | $0 | $18 | 1.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $582K |
| ACRISURE, LLC STD BROKER | Insurance agents and brokers Service code 22 | 2965 ALT 19 PALM HARBOR, FL 34683 | $2K |
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 | 1,096 | 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) | 1,096 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 841 | $437K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 841 | $437K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,096 | $511K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,096 | $511K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,096 | $511K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 888 | $891K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,096 | $542K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,096 | — |
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.