| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM BLUE CROSS BLUE SHIELD | $74K | $0 | $74K | 3.54% |
| PGM INSURANCE SERVICES, LLC3 | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | ANTHEM BLUE CROSS BLUE SHIELD | $0 | $29K | $29K | 1.40% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES, LLC | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | $0 | $11K | 4.18% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INS. SVS., LLC | 100 PASSAIC AVENUE, SUITE 120 FAIRFIELD, NJ 07004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | $0 | $10K | 4.15% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVENUE, SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $0 | $7K | 2.94% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 11.32% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.42% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVENUE, SUITE 301 ENGLEWOOD, NJ 07632 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $2K | $22K | 32.05% |
| WORKSITE WHEELHOUSE3 Filed as: WORKSITE WHEELHOUSE, LLC | 103-107 CHURCH STREET PHILADELPHIA, PA 19106 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 8.67% |
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 | 1,054 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,072 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS BLUE SHIELD | 1,054 | $2.1M |
| Dental(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 227 | $345K |
| Vision(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 227 | $345K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 227 | $345K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 227 | $251K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 255 | $414K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,054 | — |
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.