| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 12.83% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS LTD. | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $385 | $385 | 1.45% |
| ACRISURE LLC3 Filed as: ACRISURE | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | HCC LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| COMMERCIAL GROUP INTERMEDIARIES3 | 19 ILLINOIS AVE SCHAUMBURG, IL 60193 | HCC LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC3 | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS LTD. | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $499 | $499 | 2.81% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA INDUSTRIAL INS. | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS LTD. | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $205 | $205 | 1.48% |
| ACRISURE LLC3 | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $389 | $389 | 2.92% |
| ACRISURE LLC3 | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $285 | $285 | 2.65% |
| ACRISURE LLC3 | 55 SHUMAN BLVD. STE 900 NAPERVILLE, IL 60563 | RELIANCEMATRIX | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 | 55 SHUMAN BLVD. SUITE 900 NAPERVILLE, IL 60563 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $238 | — | $238 | 14.99% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $48 | $48 | 3.02% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | RELIANCEMATRIX | 195 | $10K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 130 | $32K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 130 | $26K |
| Other(5 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 130 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.