| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA WELLS3 | 10 RESEARCH PARKWAY, SUITE 400 WALLINGFORD, CT 06492 | BLUE CROSS AND BLUE SHIELD OF VERMONT | $27K | $1K | $28K | 2.45% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INS | SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL PLAN OF VERMONT, INC. | $2K | — | $2K | 4.17% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $423 | — | $423 | 0.77% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE SERVICES, LLC 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $692 | — | $692 | 6.27% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $445 | — | $445 | 4.03% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $92 | — | $92 | 0.83% |
| NEW ENGLAND EMPLOYEE BENEFITS CO3 Filed as: ARISURE NEW ENGLAND PARTNERS INS | SERVICES 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | PRINCIPAL LIFE INSURANCE COMPANY | $942 | — | $942 | 12.16% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $388 | $388 | 5.01% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HICKOK & | BOARDMAN HR INTELLIGENCE 364 SHELBURNE RD BURLINGTON, VT 05401 | PRINCIPAL LIFE INSURANCE COMPANY | $221 | — | $221 | 2.85% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $172 | $172 | 2.22% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 109 | $1.1M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 131 | $55K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 109 | $1.1M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 117 | $8K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 109 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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."
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.