| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA UNION BENEFIT | PLANNERS 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $232K | — | $232K | 15.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 1787 SENTRY PWY W VEVA 16 #320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $77K | $77K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 1787 SENTRY PWY W VEVA 16#320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $45K | $45K | 2.90% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA UNION BENEFIT | PLANNERS 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $65K | $64K | $129K | 10.92% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA UNION BENEFIT | PLANNERS 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $59K | $59K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 1787 SENTRY PWY W VEVA 16 #320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $54K | $54K | 4.55% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INSURANCE SERV | 100 PASSAIC AVENUE SUITE 120 FAIRFIELD, NJ 07004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | — | $22K | 8.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NEW ENGLAND LLC | 1667 ELM ST STE 3 MANCHESTER, NH 03101 | VISION SERVICE PLAN | $5K | — | $5K | 2.13% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $4K | — | $4K | 1.76% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36K | — | $36K | 15.38% |
| CHRISTINE M. MCCULLUGH3 Filed as: CHRISTINE WALSH | 255 WEST NECK RD. HUNTINGTON, NY 11743 | CONTINENTAL AMERICAN INSURANCE COMPANY | $136 | — | $136 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 100 SUNNYSIDE BLVD. ATTN KATHY FIEDORYSZYN WOODBURY, NY 11797 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $5K | $997 | $6K | 6.47% |
| ACRISURE LLC3 | DBA GROUP BENEFITS ADMINISTRATION 23 VREELAND ROAD, STE 180 FLORHAM PARK, NJ 07932 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $3K | — | $3K | 2.87% |
| ACRISURE LLC3 | ATTN DENNIS SCIRE 65 MADISON AVENUE, SUITE 200 MORRISTOWN, NJ 07726 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $2K | — | $2K | 2.38% |
| ACRISURE LLC3 | DBA GROUP BENEFITS ADMINISTRATION 120 EAGLE ROCK AVE, STE 195 EAST HANOVER, NJ 07936 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $471 | — | $471 | 0.50% |
| ACRISURE LLC3 | 340 MADISON AVENUE 21ST FLOOR NEW YORK, NY 10173 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $116 | $116 | 0.12% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | THE CAMPBELL GROUP 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 4.51% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | THE CAMPBELL GROUP 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE CO. | $225 | — | $225 | 5.37% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA UNION BENEFIT | PLANNERS 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $58 | $73 | $131 | 5.02% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 1787 SENTRY PWY W VEVA 16 #320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $130 | $130 | 4.98% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS | 1787 SENTRY PWY W VEVA 16#320 BLUE BELL, PA 19422 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $95 | $95 | 3.64% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | THE CAMPBELL GROUP 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE CO. | $117 | — | $117 | 5.34% |
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 | 1,655 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,707 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 23 | $269K |
| Dental(3 contracts) | AETNA LIFE INSURANCE CO. | 392 | $64K |
| Vision | VISION SERVICE PLAN | 1,345 | $235K |
| Life insurance | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 2,206 | $1.2M |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 102 | $3K |
| Long-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 1,092 | $1.5M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $10K |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 2,180 | $349K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,206 | — |
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.