| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | — | $46K | 6.19% |
| ACRISURE LLC3 | 9605 S KINGSTON CT STE 150 ENGLEWOOD, CO 80112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 1.73% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVC LLC | 354 EISENHOWER OKWY STE 2850 LIVINGSTON, NJ 07039 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 0.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $593 | $2K | 12.04% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA BENEFIT HEALTH | ADVISOR 9650 S KINGSTON CT, STE 150 ENGLEWOOD, CO 80112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $259 | — | $259 | 1.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $960 | $86 | $1K | 7.50% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | BENEFIT HEALTH ADVISOR 9605 S KINGSTON CT, STE 150 ENGLEWOOD, CO 80112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $434 | — | $434 | 3.11% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 173 | $740K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 173 | $740K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 173 | $740K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $14K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.