| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SV | 3155 OLSEN DRIVE STE 400 SAN JOSE, CA 95117 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $11K | $11K | 2.95% |
| TLR INSURANCE LLC3 | 655 WALNUT DRIVE MELBOURNE, FL 32935 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $7K | $7K | 1.93% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 1950 W CORPORATE WAY #33276 ANAHEIM, CA 92801 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 427 BENTON, KY 42025 | UNITEDHEALTHCARE INSURANCE COMPANY | — | -$259 | -$259 | -0.07% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST STREET SAN JOSE, CA 95112 | AMERITAS LIFE INSURANCE CORP | $2K | $696 | $3K | 6.81% |
| TLR INSURANCE LLC3 | 655 WALNUT DRIVE MELBOURNE, FL 32935 | AMERITAS LIFE INSURANCE CORP | $399 | — | $399 | 0.98% |
| ASSUREDPARTNERS3 Filed as: PEEL AND HOLLAND INC | — | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $11K | $11K | 41.32% |
| ACRISURE LLC3 | — | AMERICAN UNITED LIFE INSURANCE COMPANY | $4K | — | $4K | 14.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | AMERICAN UNITED LIFE INSURANCE COMPANY | $1K | — | $1K | 4.54% |
| TLR INSURANCE LLC3 | — | AMERICAN UNITED LIFE INSURANCE COMPANY | $366 | — | $366 | 1.36% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVENUE STE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.11% |
| TLR INSURANCE LLC3 | 7901 4TH STREET N #22144 ST PETERSBURG, FL 33702 | STANDARD INSURANCE COMPANY | $473 | — | $473 | 1.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 W KENNEDY BOULEVARD STE 850 TAMPA, FL 33609 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 17.15% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SV | 900 E HAMILTON AVENUE STE 500 CAMPBELL, CA 95008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $303 | — | $303 | 2.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 W KENNEDY BOULEVARD STE 850 TAMPA, FL 33609 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 31.10% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SV | 900 E HAMILTON AVENUE STE 500 CAMPBELL, CA 95008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $315 | — | $315 | 5.64% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SV | 3155 OLSEN DRIVE STE 400 SAN JOSE, CA 95117 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $183 | — | $183 | 7.33% |
| TLR INSURANCE LLC3 | 655 WALNUT DRIVE MELBOURNE, FL 32935 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $93 | — | $93 | 3.73% |
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 | 22 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 27 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 22 | $377K |
| Dental | AMERITAS LIFE INSURANCE CORP | 92 | $41K |
| Vision | AMERITAS LIFE INSURANCE CORP | 92 | $41K |
| Life insurance | STANDARD INSURANCE COMPANY | 124 | $25K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 13 | $27K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 13 | $27K |
| Other(3 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 37 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.