| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | SIGNATURE BB 501 FRANKLIN AVE, STE 218 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $984 | — | $984 | 3.01% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MI LLC | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $287 | $602 | $889 | 2.72% |
| ACRISURE LLC3 | SIGNATURE BB 501 FRANKLIN AVE, STE 218 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.49% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICE OF MI LLC | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $58 | $243 | $301 | 4.66% |
| ACRISURE LLC3 | SIGNATURE BB 501 FRANKLIN AVE, STE 218 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $170 | — | $170 | 2.63% |
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 | 146 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 88 | $33K |
| Vision | STANDARD INSURANCE COMPANY | 81 | $6K |
| Life insurance | STANDARD INSURANCE COMPANY | 147 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.