| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1375 EAST 9TH STREET, 30TH FLOOR SUITE 3000 CLEVELAND, OH 44114 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $36K | $36K | 2.59% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PTNRS INS SVCS | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $8K | $8K | 0.58% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2340 DETROIT AVENUE, SUITE 3 MAUMEE, OH 43537 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | $2K | $14K | 13.60% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2340 DETROIT AVENUE, SUITE 3 MAUMEE, OH 43537 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 8.37% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 4.19% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | COMMUNITY INSURANCE COMPANY | $4K | $0 | $4K | 30.83% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVENUE, SUITE 1500 CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $0 | $1K | $1K | 9.38% |
| ERC SERVICES INC3 Filed as: ERC SERVICES, INC. | 3333 RICHMOND ROAD, SUITE 210 BEACHWOOD, OH 44122 | COMMUNITY INSURANCE COMPANY | $532 | $0 | $532 | 4.05% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PTNRS INS SVCS | 1007 WEST HURON STREET WATERFORD, MI 48328 | COMMUNITY INSURANCE COMPANY | $111 | $0 | $111 | 0.85% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $1.4M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 123 | $50K |
| Vision | COMMUNITY INSURANCE COMPANY | 231 | $13K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 155 | $103K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 155 | $103K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 155 | $103K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $1.4M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 155 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.