| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT BERGMAN3 Filed as: ROBERT COLA | 2005 MARKET STREET PHILADELPHIA, PA 19103 | HIGHMARK | $36K | — | $36K | 3.21% |
| ACRISURE LLC3 Filed as: ACRISURE | PO BOX 976 GROVE CITY, PA 16127 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 4.98% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $8K | $8K | 4.48% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INSURANCE | 100 PASSAIC AVENUE, SUITE 120 FAIFIELD, NJ 07004 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.19% |
| ACRISURE LLC3 | 221 W PATRIOT STREET SOMERSET, PA 15501 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.15% |
| ACRISURE LLC3 | 1265 DRUMMERS LANE, SUITE 300 WAYNE, PA 19087 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 1.07% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $1K | $1K | 0.78% |
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 | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 142 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $187K |
| Vision | EYEMED | 171 | $16K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $187K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $187K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $187K |
| Prescription drug | HIGHMARK | 142 | $1.1M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.