| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK AND BOARDMAN EMPLOYEE | BENEFITS GROUP-ACRISURE PO BOX 1064 BURLINGTON, VT 05402 | BLUE CROSS AND BLUE SHIELD OF VERMONT | $22K | $5K | $27K | 2.55% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $3K | — | $3K | 4.97% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA | CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $597 | — | $597 | 0.94% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $759 | — | $759 | 6.47% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $433 | — | $433 | 3.69% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HICKOK & | BOARDMAN HR INTELLIGENCE 364 SHELBURNE RD BURLINGTON, VT 05401 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.04% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $37 | $37 | 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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 115 | $1.1M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 149 | $63K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 115 | $1.1M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 123 | $8K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 115 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.