| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 10 CHELSEA ROAD ESSEX JUNCTION, VT 05452 | STANDARD INSURANCE COMPANY | $9K | $9K | $18K | 18.23% |
| CROSS BENEFIT SOLUTIONS3 | 491 MAIN STREET BANGOR, ME 04401 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 1.58% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL PLAN OF VERMONT, INC. | $1K | $0 | $1K | 2.48% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC. | 1100 ELM STREET MANCHESTER, NH 03101 | DELTA DENTAL PLAN OF VERMONT, INC. | $676 | — | $676 | 1.25% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $475 | $0 | $475 | 0.88% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $471 | — | $471 | 0.87% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | RED TREE INSURANCE COMPANY, INC. | $315 | $0 | $315 | 4.97% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC. | 1100 ELM STREET MANCHESTER, NH 03101 | RED TREE INSURANCE COMPANY, INC. | $165 | $0 | $165 | 2.60% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | RED TREE INSURANCE COMPANY, INC. | $106 | $0 | $106 | 1.67% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $88 | $0 | $88 | 1.39% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 113 | $54K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 87 | $6K |
| Life insurance | STANDARD INSURANCE COMPANY | 126 | $99K |
| Short-term disability | STANDARD INSURANCE COMPANY | 126 | $99K |
| Long-term disability | STANDARD INSURANCE COMPANY | 126 | $99K |
| Other | STANDARD INSURANCE COMPANY | 126 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.