| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 3580 PIERCE DRIVE SUITE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 7.98% |
| ACRISURE LLC3 | 3580 PIERCE DRIVE SUITE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 8.15% |
| ACRISURE LLC3 | 3580 PIERCE DRIVE SUITE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $153 | — | $153 | 10.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMIN | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $317K |
| ACRISURE LLC BROKER | Insurance agents and brokers; Insurance services Service code 22 | 3580 PIERCE DRIE SUITE 100 CHAMBLEE, GA 30341 | $109K |
| CIGNA | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
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 | 311 | 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) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 311 | $188K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 147 | $71K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 646 | $723K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 311 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 646 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.