| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE ROAD, 5TH FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $11K | $11K | 0.88% |
| THE RICHARDS GROUP3 Filed as: RICHARDS, INC. | 48 HARRIS PLACE BRATTLEBORO, VT 05302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $9K | $9K | 0.67% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN FINANCIAL | 346 SHELBURNE ROAD, 5TH FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $7K | $7K | 0.54% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | DELTA DENTAL PLAN OF VERMONT, INC. | $3K | $0 | $3K | 2.31% |
| THE RICHARDS GROUP3 Filed as: RICHARDS, INC. | 48 HARRIS PLACE BRATTLEBORO, VT 05302 | DELTA DENTAL PLAN OF VERMONT, INC. | $1K | $0 | $1K | 0.97% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $1K | $0 | $1K | 0.96% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN FINANCIAL | 346 SHELBURNE ROAD, 5TH FLOOR BURLINGTON, VT 05401 | DELTA DENTAL PLAN OF VERMONT, INC. | $828 | $0 | $828 | 0.70% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE ROAD, 5TH FLOOR BURLINGTON, VT 05401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $584 | $6K | 7.95% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | 2 DELTA DRIVE, SUITE 301 CONCORD, NH 03301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 5.00% |
| THE RICHARDS GROUP3 | PO BOX 820 BRATTLEBORO, VT 05301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $299 | $2K | 2.36% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN FINANCIAL | PO BOX 1064 BURLINGTON, VT 05402 | VISION SERVICE PLAN | $518 | $0 | $518 | 3.56% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $284 | $0 | $284 | 1.95% |
| THE RICHARDS GROUP3 Filed as: RICHARDS, INC. | PO BOX 820 BRATTLEBORO, VT 05302 | VISION SERVICE PLAN | $228 | $0 | $228 | 1.57% |
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 | 245 | 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) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 113 | $1.3M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 260 | $117K |
| Vision | VISION SERVICE PLAN | 97 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 240 | $71K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 240 | $71K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 240 | $71K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 113 | $1.3M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 245 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.