| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 16.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $150K |
| ACRISURE, LLC EIN 26-3554645 DENT/VIS BROKER | Other commissions; Insurance agents and brokers Service code 22 | 1200 MACARTHUR BLVD SUITE 105 MAHWAH, NJ 07430 | $98K |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 DENTAL/VISION ADMIN | Claims processing Service code 12 | — | $25K |
| CENTERSTONE INSUR & FINANCIAL SERV EIN 95-4018229 DENT/VIS BROKER | Insurance agents and brokers Service code 22 | 12404 PARK CENTRAL DR SUITE 400S DALLAS, TX 07430 | $668 |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $55K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $55K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 467 | $322K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.