| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 42965 US-19 ALT PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $23K | — | $23K | 0.62% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $4K | — | $4K | 0.11% |
| ACRISURE LLC3 | 429 S KELLER RD STE 310 ORLANDO, FL 32810 | SUN LIFE ASSURANCE COMPANY OF CANADA | $95K | — | $95K | 21.41% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, WI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $6K | $6K | 1.25% |
| ACRISURE LLC3 | 2965 US-19 ALT PALM HARBOR, FL 34683 | RELIASTAR LIFE INSURANCE COMPANY | $33K | — | $33K | 15.00% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | RELIASTAR LIFE INSURANCE COMPANY | — | $11K | $11K | 5.00% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | ATTN JILL K SHULMAN 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | RELIASTAR LIFE INSURANCE COMPANY | $5K | — | $5K | 2.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Float revenue; Other services; Named fiduciary; Participant communication; Claims processing; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | — | $25K |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 103 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 0 | $3.8M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $446K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $446K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 0 | $3.8M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 280 | $218K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $446K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.
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.