| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 600 SYLVAN AVE SUITE 301 ENGLEWOOD CLIFFS, NJ 07362 | CAREFIRST BLUECHOICE, INC. | — | $66K | $66K | 5.35% |
| MATHER & STROHL ADMIN SVCS INC3 Filed as: MATHER AND STROHL ADMINISTRATIVE SE | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | — | $6K | $6K | 0.47% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SVCS LLC | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 10.22% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.14% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SVCS LLC | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 10.65% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 9.07% |
| DEPLOYEDGLOBALS3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $689 | — | $689 | 10.00% |
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 | 77 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 77 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAREFIRST BLUECHOICE, INC. | 77 | $1.2M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $37K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $25K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 77 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.