| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE ROAD 5TH FLOOR BURLINGTON, VT 05402 | HCC LIFE INSURANCE COMPANY | $59K | $0 | $59K | 6.46% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.83% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.58% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.87% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 503232317 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.35% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.76% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $297 | $0 | $297 | 0.59% |
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 | 422 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 423 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 266 | $50K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 461 | $132K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 461 | $124K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 461 | $82K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 344 | $910K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 461 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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.