| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 5TH FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $51K | $0 | $51K | 5.68% |
| ACRISURE LLC3 Filed as: ACRISURE NE P INS SVS LLC | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $0 | $4K | 0.50% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | $2K | $33K | 10.75% |
| THOMAS D RUGG3 | 346 SHELBURNE RD 5TH FLOOR BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 2.47% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $5K | $0 | $5K | 8.36% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $4K | $0 | $4K | 5.82% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $497 | $0 | $497 | 0.81% |
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 | 344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 397 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 300 | $62K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 310 | $311K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 310 | $311K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 605 | $899K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $427K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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.