| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEMDA M ENGEBRETSON3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 51351 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | — | $20K | 2.30% |
| ALMEDA M ENGEBRETSON3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 51351 | BLUE CARE NETWORK OF MICHIGAN | $13K | — | $13K | 2.35% |
| ACRISURE LLC3 | 13900 S WEST BAY SHORE DR TRAVERSE CITY, MI 49684 | COMPANION LIFE INSURANCE COMPANY | $5K | — | $5K | 2.30% |
| AGENT ALLIANCE CORPORATION3 | 500 CASCADE WEST PKWY STE 160 GRAND RAPIDS, MI 49546 | COMPANION LIFE INSURANCE COMPANY | $243 | — | $243 | 0.11% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HNI RISK SER | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $248 | $2K | 10.34% |
| ACRISURE LLC3 | PO BOX 510187 NEW BERLIN, WI 53151 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 8.67% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | PO BOX 510187 NEW BERLIN, WI 53151 | UNITEDHEALTHCARE INSURANCE COMPANY | $229 | — | $229 | 1.33% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HNI RISK SERV | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $78 | $1K | 16.12% |
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 | 383 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 233 | $1.4M |
| Dental | COMPANION LIFE INSURANCE COMPANY | 257 | $215K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 233 | $17K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 383 | $29K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 122 | $1.4M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 383 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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."
No prospect flags tripped on this filing.