| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $238K | $20K | $258K | 23.78% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 0.91% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 1.86% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $69K | $6K | $76K | 24.05% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41K | $4K | $45K | 24.56% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $700 | $700 | 1.61% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $847 | $10K | 24.04% |
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 | 1,138 | 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) | 1,138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 924 | $12.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 846 | $1.1M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 846 | $1.1M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,138 | $607K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 724 | $316K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 675 | $1.1M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,138 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,138 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.