| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA BENEFIT | SOURCES AND SOLUTION CHANDLER 100 PASSAIC AVENUE, SUITE 120 FAIRFIELD, NJ 07004 | HORIZON HEALTHCARE SERVICES, INC. | $93K | — | $93K | 2.36% |
| ACRISURE LLC3 | 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | — | $7K | 0.77% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, IN. | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | — | $7K | 0.74% |
| THOMAS P MCKIERNAN3 | 687 EAST BROADWAY MILFORD, CT 06460 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 0.50% |
| KRISTEN NICOLE POLLOCK3 | 30 WORDSWORTH LN PHILLIPSBURG, NJ 08865 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 0.42% |
| JESSICA A BOUTILETTE3 | 14 YOUMANS AVENUE WASHINGTON, NJ 07882 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.17% |
| JOSHUA P SAUNDERS3 | 17 OAK LN RANDOLPH, NJ 07869 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 0.12% |
| LORI A. VEILLETTE3 Filed as: LORI A VEILLETTE | 48 ACADEMY HILL RD EXT DERBY, CT 06418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $975 | — | $975 | 0.11% |
| DENISE POIRIER3 Filed as: DENISE COTE POIRIER | 116 WEST WALK WEST HAVEN, CT 06516 | CONTINENTAL AMERICAN INSURANCE COMPANY | $630 | — | $630 | 0.07% |
| JEANNETTE A COLE3 Filed as: JEANNETTE ANN COLE | 23 CLIFF ST EAST HAVEN, CT 06512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $602 | — | $602 | 0.07% |
| FRANK GREGORY PUTNEY3 | 11 BALAUREL DRIVE GUILFORD, CT 06437 | CONTINENTAL AMERICAN INSURANCE COMPANY | $576 | — | $576 | 0.06% |
| JOHANN S SCRIMSHIRE3 Filed as: JOHANN SCOTT SCRIMSHIRE | 125 S MAIN STREET SUITE 405 SEBASTOPOL, CA 95472 | CONTINENTAL AMERICAN INSURANCE COMPANY | $430 | — | $430 | 0.05% |
| STEPHEN WEST3 | 5 JANE ST BEACON FALLS, CT 06403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $408 | — | $408 | 0.05% |
| PATRICK RUHLE3 Filed as: PATRICK C HARDIE | 14 WALL STREET NEW YORK, NY 10005 | CONTINENTAL AMERICAN INSURANCE COMPANY | $243 | — | $243 | 0.03% |
| JUSTIN GRIFFEY3 | 444 ONCREST TER CLIFFSIDE PARK, NJ 07010 | CONTINENTAL AMERICAN INSURANCE COMPANY | $207 | — | $207 | 0.02% |
| KENNETH C GRAVELINE3 Filed as: KENNETH CARL GRAVELINE | 20 CORRINE STREET PROSPECT, CT 06712 | CONTINENTAL AMERICAN INSURANCE COMPANY | $188 | — | $188 | 0.02% |
| SAMUEL TATUM3 | 14 POWDER HORN HILL RD WILTON, CT 06897 | CONTINENTAL AMERICAN INSURANCE COMPANY | $142 | — | $142 | 0.02% |
| SAHAR QABAZARD3 | 3756 DEER TRAIL CT DANVILLE, CA 94506 | CONTINENTAL AMERICAN INSURANCE COMPANY | $118 | — | $118 | 0.01% |
| CHRISTOPHER MICHAEL MCKIERNAN3 Filed as: CHRISTOPHER MICHAEL MCKIERMAN | 2795 PINE AVE RONKONKOMA, NY 11779 | CONTINENTAL AMERICAN INSURANCE COMPANY | $94 | — | $94 | 0.01% |
| DANIEL BAKLEY3 Filed as: DANIEL JEROME BAKLEY | 2101 SEALION DR UNIT 107 LAS VEGAS, NV 89128 | CONTINENTAL AMERICAN INSURANCE COMPANY | $42 | — | $42 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA BENEFIT | SOURCES AND SOLUTION CHANDLER 100 PASSAIC AVENUE, SUITE 120 FAIRFIELD, NJ 07004 | HORIZON HEALTHCARE SERVICES, INC. | $11K | — | $11K | 1.77% |
| ACRISURE LLC3 | 100 PASSAIC AVE SUITE 120 FAIRFIELD, NJ 07004 | GUARDIAN | $26K | $14K | $40K | 10.12% |
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 | 256 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 256 | $3.9M |
| Dental | GUARDIAN | 303 | $391K |
| Vision | GUARDIAN | 303 | $391K |
| Life insurance | GUARDIAN | 303 | $391K |
| Short-term disability | GUARDIAN | 303 | $391K |
| Long-term disability | GUARDIAN | 303 | $391K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 256 | $647K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 303 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.