| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | HEALTH OPTIONS, INC. | $47K | $0 | $47K | 4.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA | $12K | $0 | $12K | 4.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | FLORIDA COMBINED LIFE | $7K | $0 | $7K | 7.02% |
| NORTH FLORIDA INSURANCE AGENCY3 | 556 LAGOON OAKS DRIVE PANAMA CITY, FL 34208 | FLORIDA COMBINED LIFE | $2K | $0 | $2K | 2.49% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 7.39% |
| ACRISURE LLC3 | 2965 ALTERNATE 19 NORTH PALM HARBOR, FL 34683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $23 | $2K | 5.53% |
| SHIRLEY B DRAKE3 | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $378 | $1K | 4.07% |
| HARRY M BARASH3 | 2510 SUMMERDALE COURT CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1 | $1K | 3.48% |
| WORKSITE AMERICA LLC3 | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $738 | $144 | $882 | 2.43% |
| SUSANNE PAPA3 | 4750 STONEVIEW CIRCLE OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $252 | $0 | $252 | 0.69% |
| MARIA ARDOLINO3 | 10406 STIRRUP WAY TAMPA, FL 33626 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $0 | $77 | 0.21% |
| PATRICIA M CARDUCCI3 Filed as: PATRICIA M COLLINS | 1708 CYPRESS TRACE DRIVE SAFETY HARBOR, FL 34695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $19 | $53 | 0.15% |
| KASSANDRA MARIE WILL3 | 2315 BARKWOOD PASS CLEARWATER, FL 33763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.02% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | USABLE LIFE | $2K | $0 | $2K | 10.73% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $1K | $0 | $1K | 5.37% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF FLORIDA, INC. | $2K | $0 | $2K | 10.00% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | USABLE LIFE | $313 | $0 | $313 | 10.76% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $156 | $0 | $156 | 5.36% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | USABLE LIFE | $198 | $0 | $198 | 11.07% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $96 | $0 | $96 | 5.37% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 124 | $1.5M |
| Dental | FLORIDA COMBINED LIFE | 145 | $98K |
| Vision | BLUE CROSS BLUE SHIELD OF FLORIDA, INC. | 142 | $18K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $64K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $62K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $62K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 124 | $1.5M |
| Other(5 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 316 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
No prospect flags tripped on this filing.