| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 310 PASSAIC AVENUE, SUITE 202 FAIRFIELD, NJ 07004 | HORIZON HEALTHCARE SERVICES, INC. | $116K | $0 | $116K | 2.29% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 310 PASSAIC AVENUE, SUITE 202 FAIRFIELD, NJ 07004 | DELTA DENTAL OF NEW JERSEY, INC. | $9K | $0 | $9K | 4.49% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 6.10% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 310 PASSAIC AVENUE, SUITE 202 FAIRFIELD, NJ 07004 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.33% |
| GETTYSBURG BNFTS ADMIN INC3 Filed as: GETTYSBURG BENEFITS ADMIN., INC. | UNKNOWN FAIRFIELD, NJ 07004 | ASSURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 6.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 180 RIVER ROAD, 2ND FLOOR SUMMIT, NY 07901 | ASSURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.40% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | ASSURITY LIFE INSURANCE COMPANY | $59 | $0 | $59 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHEAST LIMITED | 180 RIVER ROAD, 2ND FLOOR SUMMIT, NY 07901 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $8 | $1K | 5.27% |
| IRUS CORPORATION3 | 923 MARLBOROUGH STREET PHILADELPHIA, PA 19125 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.06% |
| JOSHUA LACHS3 | 5414 SHIRLEY AVENUE TARZANA, CA 91356 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.02% |
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 | 316 | 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) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 261 | $5.1M |
| Dental | DELTA DENTAL OF NEW JERSEY, INC. | 504 | $190K |
| Vision | VISION SERVICE PLAN | 270 | $42K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 316 | $188K |
| Short-term disability(2 contracts, 2 carriers) | ASSURITY LIFE INSURANCE COMPANY | 171 | $60K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 316 | $160K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 261 | $5.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 316 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.