| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALTERNATE 19 NORTH PALM HARBOR, FL 34683 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 9.18% |
| ACRISURE LLC3 | 2965 ALTERNATE 19 NORTH PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25K | $7K | $32K | 14.84% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 3.68% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 24.42% |
| GETTYSBURG BNFTS ADMIN INC3 Filed as: GETTYSBURG BENEFITS ADMIN INC | PO BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 17.34% |
| SCOTT REYNOLDS3 | 423 TROON CIRCLE DAVENPORT, FL 33897 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $853 | — | $853 | 7.43% |
| PATRICK KIRCHNER3 | 9500 KOGER BLVD SUITE 200 ST PETERSBURG, FL 33702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $521 | — | $521 | 4.54% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $897 | — | $897 | 28.51% |
| GETTSBURG BENEFITS ADMIN INC.3 Filed as: GETTSBURG BENEFITS ADMIN INC | PO BOX 1060 GETTYSBURG, PA 17325 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $598 | — | $598 | 19.01% |
| SCOTT REYNOLDS3 | 423 TROON CIRCLE DAVENPORT, FL 33897 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $256 | — | $256 | 8.14% |
| ACRISURE LLC3 | ALLTRUST INSURANCE 2965 ALT 9 PALM HARBOR, FL 34683 | METLIFE LEGAL PLANS OF FLORIDA | $211 | $243 | $454 | 20.02% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | EMPLOYEE BENEFIT SERVICES 489 SEMINOLE ROAD MUSKEGON, MI 49444 | METLIFE LEGAL PLANS OF FLORIDA | — | $14 | $14 | 0.62% |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 142 | $385K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $215K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $215K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $215K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $215K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $215K |
| Other(5 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $242K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.