| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $8K | — | $8K | 2.00% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL PLAN OF VERMONT, INC. | $4K | — | $4K | 0.99% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | 8.05% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 3.32% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $402 | — | $402 | 0.24% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DR STE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $11K | $11K | 8.02% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.90% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $332 | — | $332 | 0.25% |
| COMBINED SERVICES LLC3 | 2 DELTA DR STE 301 CONCORD, NH 03301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 8.05% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.16% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $220 | — | $220 | 0.24% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 2.47% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE SERVICES LLC 10 RESEARCH PKWY, STE 400 GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | — | $1K | 1.91% |
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 | 381 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 762 | $412K |
| Vision | VISION SERVICE PLAN | 392 | $73K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 438 | $135K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 438 | $166K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 438 | $91K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 438 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 762 | — |
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.