| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SERVICES GROUP, INC.3 | PO BOX 6762 CAROL STREAM, IL 60197 | HUMANA INSURANCE COMPANY | $20K | $269 | $20K | 1.01% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HNI RISK SERVICES | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | HUMANA INSURANCE COMPANY | $15K | $636 | $16K | 0.82% |
| THE BENEFITS SERVICES GROUP INC3 Filed as: BENEFITS SERVICES GROUP, INC. | PO BOX 6762 CAROL STREAM, IL 60197 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 4.92% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MO 49546 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 1.51% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 1.29% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 292 | $2.0M |
| Vision | HUMANA INSURANCE COMPANY | 292 | $2.0M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $99K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $99K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.