| 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 | $55K | $21K | $76K | 11.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $2K | $13K | 8.40% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.35% |
| 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, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | UNUM INSURANCE COMPANY | $0 | $111 | $111 | 1.25% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE RD 3RD FLOOR BURLINGTON, VT 05401 | UNUM INSURANCE COMPANY | $620 | $99 | $719 | 12.62% |
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 | 325 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 181 | $61K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $158K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $158K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 533 | $688K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.