| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $34K | $0 | $34K | 11.55% |
| GA SOLUTIONS LLC3 Filed as: GA SOLUTIONS, LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 4.53% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.44% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1265 DRUMMERS LANE, SUITE 300 WAYNE, PA 19087 | VISION BENEFITS OF AMERICA | $487 | $0 | $487 | 3.47% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENCE BLUE CROSS | 232 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 284 | $292K |
| Vision | VISION BENEFITS OF AMERICA | 106 | $14K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 284 | $292K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 284 | $292K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 284 | $292K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 232 | $1.6M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 284 | $292K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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."
No prospect flags tripped on this filing.