| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE SOUTHEAST PARTNERS INSURAN | 1317 CITIZENS BLVD LEESBURG, FL 34748 | BLUE CROSS BLUE SHIELD OF FLORIDA | $35K | — | $35K | 2.87% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHEAST PARTNERS INSURAN | 1317 CITIZENS BLVD LEESBURG, FL 34748 | HEALTH OPTIONS, INC | $3K | — | $3K | 4.59% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $775 | — | $775 | 14.99% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $610 | — | $610 | 15.01% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $541 | — | $541 | 15.01% |
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 | 111 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 75 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 73 | $47K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $22K |
| Prescription drug | HEALTH OPTIONS, INC | 6 | $72K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.