| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $883 | $6K | 16.95% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH | 325 NORTH KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $20 | $2K | 4.53% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | BEAZLEY INSURANCE COMPANY INC. | $4K | $0 | $4K | 13.00% |
| WORKSITE WHEELHOUSE3 | 103-107 CHURCH STREET PHILADELPHIA, PA 19106 | BEAZLEY INSURANCE COMPANY INC. | $2K | $0 | $2K | 5.00% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $1K | $2K | 12.28% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $793 | $0 | $793 | 4.13% |
| ACRISURE LLC3 | 200 NORTH WARNER ROAD, SUITE 450A KING OF PRUSSIA, PA 19406 | VISION SERVICE PLAN | $460 | $0 | $460 | 10.76% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, PA 50323 | VISION SERVICE PLAN | $256 | $0 | $256 | 5.99% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $146 | $48 | $194 | 12.54% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $66 | $0 | $66 | 4.27% |
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 | 93 | 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) | 93 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY AND AFFILIATES | 93 | $954K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 65 | $21K |
| Vision | VISION SERVICE PLAN | 41 | $4K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $36K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 31 | $36K |
| Prescription drug | CIGNA HEALTH & LIFE INSURANCE COMPANY AND AFFILIATES | 93 | $924K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 59 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.