| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $121K | $17K | $138K | 5.68% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SERVICES LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $41K | $41K | 1.71% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 12.81% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 4.17% |
| PROFILE BENEFITS INC.3 Filed as: PROFILE BENEFITS | 320 SOUTH SERVICE ROAD MELVILLE, NY 11747 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.28% |
| DONALD C SAVOY INC3 | ROUND TABLE STUDIOS SUITE 1000, 200 CORNELL DRIVE BERKELEY HEIGHTS, NJ 07922 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $817 | $817 | 0.41% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 307 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 312 | $2.6M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 312 | $2.6M |
| Vision(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 312 | $2.6M |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 312 | $198K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 312 | $198K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 312 | $198K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 312 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.