| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | COREY LILBURN 5411 SKY CENTER DR, SUITE 600 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $240K | — | $240K | 3.50% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC. | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | FLORIDA COMBINED LIFE | $36K | — | $36K | 9.89% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $28K | — | $28K | 15.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 4.74% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | — | $18K | 12.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 4.78% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.17% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.55% |
| ACRISURE LLC3 | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | BLUECROSS BLUESHIELD OF FLORIDA, INC. | $3K | — | $3K | 9.88% |
| 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 | $4K | — | $4K | 15.00% |
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 | 400 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 395 | $6.9M |
| Dental | FLORIDA COMBINED LIFE | 397 | $362K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 395 | $6.9M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 400 | $227K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $55K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 400 | $184K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 400 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.