| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE MID-ATLANTIC PARTNERS | 1265 DRUMMERS LN STE 300 WAYNE, PA 19087 | HIGHMARK, INC. | $27K | — | $27K | 3.21% |
| DJME VENTURES, INC.3 | 902 S CENTER STREET P.O. BOX 972 GROVE CITY, PA 16127 | HIGHMARK, INC. | $12K | — | $12K | 1.44% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 | 902 SOUTH CENTER STREET P.O. BOX 976 GROVE CITY, PA 16127 | GUARDIAN | $13K | $4K | $17K | 15.88% |
| ACRISURE LLC3 Filed as: ACRISURE MID-ATLANTIC PARTNERS | 1265 DRUMMERS LN STE 300 WAYNE, PA 19087 | GUARDIAN | — | $2K | $2K | 1.84% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFITS CONSULTANTS, INC. | 902 S CENTER STREET GROVE CITY, PA 16127 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 14.49% |
| ACRISURE LLC3 Filed as: ACRISURE MID-ATLANTIC PARTNERS | 1265 DRUMMERS LN STE 300 WAYNE, PA 19087 | HIGHMARK, INC. | $311 | — | $311 | 3.04% |
| DJME VENTURES, INC.3 | 902 S CENTER STREET P.O. BOX 976 GROVE CITY, PA 16127 | HIGHMARK, INC. | $137 | — | $137 | 1.34% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 139 | $830K |
| Dental | GUARDIAN | 141 | $107K |
| Vision | HIGHMARK, INC. | 122 | $10K |
| Life insurance | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 170 | $37K |
| Short-term disability | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 170 | $37K |
| Prescription drug | HIGHMARK, INC. | 139 | $830K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 170 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.