| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS INS | SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $4K | — | $4K | 5.00% |
| COMBINED SERVICES LLC3 | DBA CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $778 | — | $778 | 0.95% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 7.73% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 12.18% |
| ACRISURE LLC3 | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 8.04% |
| ACRISURE LLC3 Filed as: ACRISURE NEW ENGLAND PARTNERS | INSURANCE SERVICES, LLC 10 RESEARCH PKWY, STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $838 | — | $838 | 6.72% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $749 | — | $749 | 6.00% |
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 | 134 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH PLAN INC | 144 | $1.7M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 173 | $82K |
| Vision | VISION SERVICE PLAN | 72 | $12K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 127 | $25K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 105 | $44K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 127 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.