| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: FULCRO INSURANCE, INC | PO BOX 9024048 SAN JUAN, PR 009024048 | HUMANA INSURANCE OR PUERTO RICO, INC. | $61K | — | $61K | 9.18% |
| ACRISURE LLC3 Filed as: FULCRO INSURANCE | PO BOX 9024048 SAN JUAN, PR 009024048 | TRIPLE-S VIDA, INC. | $20K | — | $20K | 15.00% |
| ACRISURE LLC3 Filed as: FULCRO INSURANCE | PO BOX 9024048 SAN JUAN, PR 00901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 13.81% |
| INNOVA INSURANCE3 | PO BOX 299 MERCEDITA, PR 00715 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$516 | $6K | $6K | 4.60% |
| ACRISURE LLC3 Filed as: FULCRO INSURANCE | PO BOX 9024048 SAN JUAN, PR 00901 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 14.63% |
| INNOVA INSURANCE3 Filed as: INNOVA ONSURANCE | PO BOX 299 MERCEDITA, PR 00715 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$11 | $1K | $1K | 4.91% |
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 | 878 | 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) | 878 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE OR PUERTO RICO, INC. | 865 | $668K |
| Dental | HUMANA INSURANCE OR PUERTO RICO, INC. | 865 | $668K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 878 | $125K |
| Long-term disability | TRIPLE-S VIDA, INC. | 870 | $134K |
| Prescription drug | HUMANA INSURANCE OR PUERTO RICO, INC. | 865 | $668K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 878 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 878 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.