| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JERRY LEON MCPETERS3 Filed as: JERRY MCPETERS, GROUP & PENSION ADM | 12770 MERIT DR FLOOR 2 DALLAS, TX 752511209 | RELIASTAR LIFE INSURANCE COMPANY | $23K | — | $23K | 3.38% |
| COST PLUS ADVISORS LLC3 Filed as: COST PLUS ADIVSORS, LLC | 31274 SUGAR HILL LANE EVERGREEN, CO 804398000 | RELIASTAR LIFE INSURANCE COMPANY | $22K | — | $22K | 3.23% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 US 19 ALT PALM HARBOR, FL 34683 | RELIASTAR LIFE INSURANCE COMPANY | $14K | — | $14K | 2.13% |
| ALLTRUST INSURANCE3 Filed as: ALLTRUST INSURANCE, INC. | 2965 ALT 19 PALM HARBOR, FL 346831907 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 1.25% |
| ACRISURE LLC3 Filed as: ACRISURE DBA ALLTRUST INSURANCE | 2965 ALT 19 NORTH PALM BEACH, FL 34683 | CIGNA | $39K | $5K | $44K | 9.60% |
| COST PLUS ADVISORS LLC3 | 31274 SUGARHILL LANE EVERGREEN, CO 80439 | CIGNA | $7K | — | $7K | 1.59% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | ALLSTATE | $70K | — | $70K | 53.06% |
| COST PLUS ADVISORS LLC3 Filed as: COST PLUS ADVISORS | 31274 SUGARHILL LANE EVERGREEN, CO 80439 | ALLSTATE | $21 | — | $21 | 0.02% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA ALL TRUST INSURANC | 2965 ALT 19 PALM HARBOR, FL 34683 | ADVANTICA INSURANCE INC. | $10K | — | $10K | 9.64% |
| COST PLUS ADVISORS LLC3 | 4479 EAST MEADOW DRIVE #2005 VAIL, CO 81657 | ADVANTICA INSURANCE INC. | $3K | — | $3K | 3.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP & PENSION ADMINISTRATORS, INC TPA | Insurance services Service code 23 | 12770 MERIT DRIVE DALLAS, TX 75251 | $7K |
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 | 1,047 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,047 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ADVANTICA INSURANCE INC. | 1,208 | $107K |
| Life insurance | CIGNA | 1,047 | $462K |
| Long-term disability | CIGNA | 1,047 | $462K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 1,044 | $667K |
| Other(2 contracts, 2 carriers) | CIGNA | 1,047 | $594K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,208 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.