| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 7.06% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 4.36% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.86% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC. | 4552 STATE RT 51 BELLE VERNON, PA 15012 | VISION BENEFITS OF AMERICA | $344 | $0 | $344 | 3.99% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $996 | $26 | $1K | 14.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL J SLATER | 1624 HOLLY HILL DRIVE BETHEL PARK, PA 15102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 1.19% |
| HUNTINGTON INSURANCE INC3 | 221 SOUTH CHURCH STREET BOWLING GREEN, OH 43402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.83% |
| TIMOTHY J SLATER3 | 466 CARNEGIE DRIVE PITTSBURGH, PA 15243 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.67% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 15012 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.29% |
| WILLIAM E GOOD3 Filed as: WILLIAM E GOOD AND OTHER AGENTS | 545 TOM SAWYER ROAD DRIPPING SPRINGS, TX 78620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.20% |
| DAVID E HAUCK3 | 5125 SHORELINE WAY VERMILION, OH 44089 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.18% |
| HENDERSON BROTHERS, INC.3 Filed as: HENDERSON BROTHERS INC | UNKNOWN PITTSBURGH, PA 15222 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.13% |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 160 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $121K |
| Vision | VISION BENEFITS OF AMERICA | 120 | $9K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $121K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $121K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $128K |
| Prescription drug | HIGHMARK, INC. | 160 | $1.3M |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 220 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.