| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK BOARDMAN FIN PLAN GRP BEN | 346 SHELBURNE RD FL 5 PO BOX 1064 BURLINGTON, VT 054021064 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $23K | — | $23K | 6.28% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | DBA HICKOK BOARDMAN HR INTEL PO BOX 1064 BURLINGTON, VT 054021064 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | — | $15K | 3.92% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK BOARDMAN FIN PLAN GRP BEN | 346 SHELBURNE RD, 5TH FLOOR PO BOX 1064 BURLINGTON, VT 054021064 | NORTHEAST DELTA DENTAL | $2K | — | $2K | 3.77% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | NORTHEAST DELTA DENTAL | $1K | — | $1K | 1.79% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE | PO BOX 1320 CONCORD, NH 033021320 | NORTHEAST DELTA DENTAL | $579 | — | $579 | 0.93% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN PLAN&GRP BEN | 346 SHELBURNE RD, 5TH FLOOR PO BOX 1064 BURLINGTON, VT 054021064 | VISION SERVICE PLAN | $690 | — | $690 | 5.29% |
| ACRISURE LLC3 | DBA HICKOK BOARDMAN HR INTELLIGENCE PO BOX 1064 BURLINGTON, VT 054021064 | PRINCIPAL LIFE INSURANCE COMPANY | $691 | — | $691 | 9.27% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK BOARDMAN FIN PLAN GRP BEN | 346 SHELBURNE RD, 5TH FLOOR PO BOX 1064 BURLINGTON, VT 054021064 | PRINCIPAL LIFE INSURANCE COMPANY | $426 | — | $426 | 5.71% |
| ACRISURE LLC3 | 265 W PETERSON AVE CHICAGO, IL 606594004 | PRINCIPAL LIFE INSURANCE COMPANY | — | $36 | $36 | 0.48% |
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 | 114 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $371K |
| Dental | NORTHEAST DELTA DENTAL | 108 | $62K |
| Vision | VISION SERVICE PLAN | 101 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 114 | $7K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $371K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $371K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $371K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.