| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | DELTA DENTAL PLAN OF VERMONT, INC. | $5K | — | $5K | 3.73% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $1K | — | $1K | 0.96% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN PLANNING | 346 SHELBURNE ROAD PO BOX 1064 BURLINGTON, VT 05401 | DELTA DENTAL PLAN OF VERMONT, INC. | $778 | — | $778 | 0.64% |
| HICKOK & BOARDMAN FINANCIAL3 Filed as: HICKOK & BOARDMAN FIN PLANNING | PO BOX 1064 BURLINGTON, VT 05402 | VISION SERVICE PLAN | $1K | — | $1K | 4.97% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD | $3K | $99 | $3K | 13.41% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD | $1K | — | $1K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD | $2K | $83 | $2K | 8.46% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD | $1K | — | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF VT EIN 03-0277307 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Insurance services Service code 12 | — | $146K |
| HICKOK AND BOARDMAN EMPLOYEE BENEFI BROKER | Insurance brokerage commissions and fees Service code 53 | — | $42K |
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $3K |
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 | 328 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 325 | $121K |
| Vision | VISION SERVICE PLAN | 161 | $27K |
| Life insurance | RELIANCE STANDARD | 203 | $24K |
| Long-term disability | RELIANCE STANDARD | 167 | $25K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 328 | $659K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.