| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | $4K | $18K | 12.16% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN & ASSOCIATES | 2338 IMMOKALEE RD SUITE 240 NAPLES, FL 34110 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 3.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | SECURIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 2.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | VISION SERVICE PLAN | $2K | — | $2K | 4.55% |
| CLEARY BENEFITS GROUP, INC.3 | 83 WOOSTER HEIGHTS ROAD DANBURY, CT 06810 | METLIFE LEGAL PLANS | $1K | — | $1K | 10.07% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVE, STE. 301 ENGLEWOOD CLIFFS, NJ 07632 | ZURICH AMERICAN INSURANCE COMPANY | $834 | — | $834 | 14.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | SECURIAN LIFE INSURANCE COMPANY | $81 | — | $81 | 1.99% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES - | EDUCATION, INC. 111 JOHN STREET, STE 750 NEW YORK, NY 10038 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA, | $997 | — | $997 | 29.99% |
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 | 261 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ADVOCATE SOLUTIONS, INC. | 263 | $21K |
| Dental | AETNA LIFE INSURANCE CO. | 24 | $8K |
| Vision | VISION SERVICE PLAN | 196 | $42K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,443 | $195K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 261 | $144K |
| Other(5 contracts, 5 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 394 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,443 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.