| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 346 SHELBURNE RD FIFTH FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 3.08% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 14.45% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INSUR | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $176 | — | $176 | 0.41% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.18% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INSUR | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $223 | — | $223 | 1.19% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $993 | $3K | 14.57% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INSUR | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $148 | — | $148 | 0.80% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $1K | — | $1K | 6.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $873 | — | $873 | 4.87% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE SERVICES, LLC 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $159 | — | $159 | 0.89% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $873 | $2K | 14.57% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INSUR | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $131 | — | $131 | 0.81% |
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 | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 116 | $120K |
| Vision | VISION SERVICE PLAN | 110 | $18K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $18K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $43K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.