| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND & CO. | 725 RXR PLAZA, EAST TOWER UNIONDALE, NY 11556 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $75K | $3K | $78K | 3.10% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND & COMPANY LLC | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | FIRST UNUM LIFE INSURANCE COMPANY | $9K | $2K | $10K | 11.54% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND & COMPANY LLC | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $65 | $1K | 15.25% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NORTH CAROLINA, | 109 PROFESSIONAL PARK DRIVE MOORESVILLE, NC 28117 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 1.16% |
| ACRISURE LLC3 Filed as: CHERNOFF DIAMOND & COMPANY LLC | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $12K |
| CIGNA EIN 59-1031071 ADMINISTRATOR | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $12K |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 252 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 252 | $2.5M |
| Vision | VISION SERVICE PLAN | 264 | $27K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 276 | $98K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 276 | $89K |
| Other(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 276 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.