| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JEFFERY A SCHULTZ3 | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | PRIORITY HEALTH | $27K | $0 | $27K | 2.00% |
| JAMES MCKINLEY3 Filed as: JAMES N MCKINLEY | 1543 BROOKWOOD DRIVE MUSKEGON, MI 49441 | PRIORITY HEALTH | $14K | $0 | $14K | 1.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONI, MI 49316 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 2.97% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $433 | $8K | 13.05% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.25% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2163 UNIVERSITY PARK DRIVE SUITE 200 OKEMOS, MI 48864 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $8 | $8 | 0.05% |
| JEREMY SAMPSEL3 | 401 HALL STREET SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2K | $3K | 21.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 8.83% |
| DIANNA LYNN ATCHISON3 | 225 EAST DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $953 | $177 | $1K | 8.65% |
| RICHARD LEWIS MULLIGAN3 | 441 HOWARD STREET SE GRAND RAPIDS, MI 49507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $415 | $2 | $417 | 3.19% |
| DENA ANN MARTHA3 | 225 EAST DIVISION STREET ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $221 | $2 | $223 | 1.71% |
| KIMBERLY JILL ZBIKOWSKI3 Filed as: KIMBERLY ZBIKOWSKI AND MISC AGENTS | 1786 DEEPWOOD DRIVE SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $59 | $109 | 0.83% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $0 | $100 | 0.77% |
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 | 391 | 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) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 228 | $1.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 345 | $105K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 309 | $16K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 410 | $71K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $13K |
| Prescription drug | PRIORITY HEALTH | 228 | $1.4M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 410 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 410 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.