| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 8430 ENTERPRISE CIRCLE SUITE 110 LAKEWOOD RANCH, FL 34202 | BLUE CROSS BLUE SHIELD OF FLORIDA | $26K | — | $26K | 4.20% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | BLUE CROSS BLUE SHIELD OF FLORIDA | $5K | — | $5K | 0.80% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE | $2K | $1K | $3K | 7.05% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE | $218 | — | $218 | 0.49% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 13.23% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $465 | — | $465 | 1.57% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 12.72% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $412 | — | $412 | 1.57% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $823 | $2K | 13.21% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $279 | — | $279 | 1.65% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 N PALM HARBOR, FL 34683 | ADVANTICA INSURANCE COMPANY | $2K | — | $2K | 11.83% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | ADVANTICA INSURANCE COMPANY | $213 | — | $213 | 1.55% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 101 | $622K |
| Dental | UNITED OF OMAHA LIFE INSURANCE | 249 | $45K |
| Vision | ADVANTICA INSURANCE COMPANY | 177 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $17K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 101 | $622K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.