| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $45K | $20K | $65K | 8.97% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INS | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $2K | $6K | 0.83% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $14K | 7.83% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.74% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INS | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $500 | $0 | $500 | 1.00% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOCK & BOARDMAN INC | PO BOX 1064 BURLINGTON, VT 054021064 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM INSURANCE COMPANY | $0 | $96 | $96 | 0.75% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM INSURANCE COMPANY | $839 | $101 | $940 | 11.70% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INS SVCS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $987 | $0 | $987 | 36.56% |
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 | 329 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 199 | $50K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 329 | $175K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 329 | $175K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 540 | $728K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 329 | $225K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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.