| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 540 MILL ST BELLEVILLE, NJ 07109 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 13.32% |
| JENNIFER L FREEMAN3 | 5520 MELANIE CIR ELIZABETH, CO 80107 | AFLAC | $1K | — | $1K | 2.88% |
| ACRISURE LLC3 | 9605 S KINGSTON CT, STE 150 ENGLEWOOD, CO 80112 | AFLAC | $1K | — | $1K | 2.86% |
| JEREMY M EANES3 | 21729 E MERCER PL AURORA, CO 80018 | AFLAC | $575 | $26 | $601 | 1.66% |
| ROMAN THOMAS SORIA3 | 2346 W TURNER RD LODI, CA 95242 | AFLAC | $413 | — | $413 | 1.14% |
| REGINA K SANTANGELO3 | 6892 S WEBSTER WAY LITTLETON, CO 80128 | AFLAC | $371 | — | $371 | 1.03% |
| ZACHARY DANIEL HOLLON3 | 2891 W LONG CIR, APT H LITTLETON, CO 80120 | AFLAC | $269 | $6 | $275 | 0.76% |
| BEVERLY L WEAVER3 | 152 E MARSHALL ST WAYNESVILLE, NC 28786 | AFLAC | $188 | — | $188 | 0.52% |
| DAYTON LLC3 | 5445 DTC PKWY, STE 1036 GREENWOOD VILLAGE, CO 80111 | AFLAC | $173 | $6 | $179 | 0.50% |
| LINDSAY A LIJEWSKI3 | 5445 DTC PKWY, STE 1036 GREENWOOD VILLAGE, CO 80111 | AFLAC | $35 | — | $35 | 0.10% |
| RONNIE S MONTANO3 | 10573 ODIN DR COLORADO SPRINGS, CO 80924 | AFLAC | $28 | — | $28 | 0.08% |
| COLLEEN J LEBSACK3 | 5048 FAWN RIDGE WAY CASTLE ROCK, CO 80104 | AFLAC | $20 | — | $20 | 0.06% |
| NANCY LAPHAM3 Filed as: NANCY L HARMON | PO BOX 1168 EDEN, UT 84310 | AFLAC | $19 | — | $19 | 0.05% |
| LARRY HIGMAN3 Filed as: LARRY D HIGMAN | 34723 COUNTY ROAD 21 ELIZABETH, CO 80107 | AFLAC | $19 | — | $19 | 0.05% |
| JAMES M GARNER3 | 10701 MELODY DR NORTHGLENN, CO 80234 | AFLAC | $18 | — | $18 | 0.05% |
| ROBERT MOLLENDOR3 | 625 MINDY CT STERLING, CO 80751 | AFLAC | $16 | — | $16 | 0.04% |
| GAYLE M MONTANO3 | 1512 ANDERSON DR WEBB CITY, MO 64870 | AFLAC | $15 | — | $15 | 0.04% |
| VICTOR M GLAZE3 | 402 PLOWMAN CT FORT COLLINS, CO 80526 | AFLAC | $10 | — | $10 | 0.03% |
| AMY M EANES3 Filed as: AMY EANES | 21729 E MERCER PL AURORA, CO 80018 | AFLAC | $8 | — | $8 | 0.02% |
| DAVID V PAYNE3 | 225 EAGLE CT MONROE, MI 48162 | AFLAC | $4 | — | $4 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | BENEFIT HEALTH ADVISOR 9605 S KINGSTON CT, STE 150 ENGLEWOOD, CO 80112 | VISION SERVICE PLAN | $3K | — | $3K | 9.84% |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 209 | $26K |
| Life insurance | STANDARD INSURANCE COMPANY | 353 | $53K |
| Other | AFLAC | 31 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.