| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $90K | $0 | $90K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | HEALTH OPTIONS, INC. | $81K | $0 | $81K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $5K | $18K | 13.54% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2163 UNIVERSITY PARK DRIVE SUITE 200 OKEMOS, MI 48864 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $80 | $80 | 0.06% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 15.92% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.21% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | $0 | $6K | 21.99% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $1K | $4K | 15.63% |
| ACRISURE LLC3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | EYEMED ON BEHALF OF THE FIFELITY SECURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.91% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5411 SKYCENTER DRIVE SUITE 600 TAMPA, FL 33607 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.00% |
| SAMUEL R MORRIS JR3 | 1776 AHL DRIVE JACKSONVILLE, FL 32224 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $636 | $0 | $636 | 3.42% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $355 | $190 | $545 | 15.35% |
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 | 323 | 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) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 132 | $3.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 741 | $136K |
| Vision | EYEMED ON BEHALF OF THE FIFELITY SECURITY LIFE INSURANCE COMPANY | 323 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 323 | $4K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 93 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $30K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 132 | $3.4M |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 323 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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.