| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE COMPANY | $136K | $110 | $136K | 5.40% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA HEALTH, INC. | $80K | $11K | $92K | 5.58% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS INC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | EYEMED VISION CARE | $5K | — | $5K | 10.04% |
| JOHNSON RESOURCES3 | 7373 E DOUBLETREE RANCH, #200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE | $959 | — | $959 | 2.01% |
| VARIOUS - SEE ATTACHED3 | C/O COLONIAL PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $926 | — | $926 | 7.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $165 | $2K | 16.29% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $85 | $85 | 0.71% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $2K | — | $2K | 28.83% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $142 | — | $142 | 2.42% |
| ROBERT SHEESLEY4 | 1001 ISLINGTON STREET, APT 53 PORTSMOUTH, NH 03801 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $60 | — | $60 | 1.02% |
| DOMINIC A. NACCHIA4 | 2151 CUMBERLAND PARKWAY APT 1216 ATLANTA, GA 30339 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $22 | — | $22 | 0.38% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS INC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $767 | — | $767 | 14.64% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $454 | $27 | $481 | 10.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | FIRST UNUM LIFE INSURANCE COMPANY | $95 | $9 | $104 | 26.33% |
| ASSUREDPARTNERS3 Filed as: BENEIFT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | FIRST UNUM LIFE INSURANCE COMPANY | — | $5 | $5 | 1.27% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS- SEE ATTACHED | C/O PAUL REVERE PO BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | — | $17 | 7.62% |
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 | 424 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 433 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 421 | $4.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 421 | $2.5M |
| Vision | EYEMED VISION CARE | 501 | $48K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 421 | $2.5M |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 30 | $12K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 421 | $2.5M |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 421 | $4.2M |
| Other(6 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 421 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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.