| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 346 SHELBURNE ROAD 5TH FLOOR BURLINGTON, VT 05401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $23K | $23K | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1550 AVIATION PKWY STE 300 MORRISVILLE, NC 27560 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $7K | $7K | 0.51% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL PLAN OF VERMONT, INC. | $2K | — | $2K | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL PLAN OF VERMONT, INC. | $952 | — | $952 | 1.30% |
| ACRISURE LLC3 Filed as: ACRISURE N.E. PARTNERS INS SVCS LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL PLAN OF VERMONT, INC. | $780 | — | $780 | 1.06% |
| ACRISURE LLC3 | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $143 | $2K | 8.19% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ACRISURE LLC3 | 364 SHELBOURNE ROAD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $339 | $4K | 13.05% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ACRISURE LLC3 | 364 SHELBURNE RD BURLINGTON, VT 05401 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $274 | $3K | 10.44% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $544 | — | $544 | 3.88% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $538 | — | $538 | 3.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $500 | — | $500 | 3.56% |
| ACRISURE LLC3 Filed as: ACRISURE N.E. PARTNERS INS SVCS LLC | 10 RESEARCH PKWY STE 400 WALLINGFORD, CT 06492 | VISION SERVICE PLAN | $154 | — | $154 | 1.10% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $63 | — | $63 | 0.45% |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 195 | $1.3M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 314 | $73K |
| Vision | VISION SERVICE PLAN | 128 | $14K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 179 | $29K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 131 | $28K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 127 | $28K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 179 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.