| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 1375 EAST 9TH STREET CLEVELAND, OH 44114 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $121K | $54K | $175K | 6.33% |
| MARSH & MCLENNAN AGENCY LLC3 | 6480 ROCKSIDE WOODS BLVD S #210 INDEPENDENCE, OH 44131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 0.60% |
| ACRISURE LLC3 | P.O. BOX 1788 GRAND RAPIDS, WI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | — | $15K | 0.90% |
| ACRISURE LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | — | $11K | 11.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $671K |
| TELEDOC SERVICE | Other services Service code 49 | — | $126K |
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 | 1,343 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,371 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,165 | $1.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,165 | $1.7M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,335 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,335 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.