| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM BLUE CROSS | $112K | $0 | $112K | 3.77% |
| PGM INSURANCE SERVICES, LLC3 | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | ANTHEM BLUE CROSS | $0 | $40K | $40K | 1.35% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INS. SVCS, LLC | 100 PASSAIC AVENUE, SUITE 120 FAIRFIELD, NJ 07004 | ANTHEM BLUE CROSS | $26K | $0 | $26K | 0.86% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | SYLVAN AVENUE, SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $621 | $260 | $881 | 9.02% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SERVICES | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $488 | $488 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INS. SVCS, LLC | 100 PASSAIC AVENUE, SUITE 120 FAIRFIELD, NJ 07004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $356 | $0 | $356 | 3.64% |
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 | 286 | 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) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 342 | $3.0M |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 342 | $3.0M |
| Vision | ANTHEM BLUE CROSS | 342 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.