| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARRY M BAXTER III3 Filed as: HARRY M. BAXTER III | 5075 CASCADE ROAD GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $15K | — | $15K | 3.42% |
| HARRY M BAXTER III3 Filed as: HARRY M BAXTER, III | 5075 CASCADE RD SE STE L GRAND RAPIDS, MI 495463751 | AMERITAS LIFE INSURANCE CORPORATION | $34K | $4K | $38K | 9.69% |
| HARRY M BAXTER III3 | 5075 CASCADE RD SE, SUITE L GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 11.30% |
| ASR HEALTH BENEFITS3 | 618 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | AIG LIFE INSURANCE COMPANY | $11K | — | $11K | 10.00% |
| HARRY M BAXTER III3 | 5075 CASCADE RD SE, SUITE L GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 25.97% |
| ENROLL FORCE, LLC3 Filed as: ENROLL FORCE LLC | 503 FORREST PARK CT HUNTSVILLE, AL 35806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.29% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $190 | — | $190 | 3.76% |
| MARY LOU TAYLOR3 | 3016 SPRING HILL PARKWAY SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 2.06% |
| JAMES A SMAARDYK3 Filed as: JAMES M TAYLOR | 3016 SPRING HILL PARKWAY SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.10% |
| THE CRAFT AGNECY INC3 | 2533 SPRING ARBOR RD JACKSON, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 3.45% |
| LAURA ANN MARSHALL3 | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 3.27% |
| TIFFANIE MARIE UNDERWOOD3 | 4601 FELLA STREET SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.78% |
| AON CONSULTING INC3 | 200 EAST RANDOLPH CHICAGO, IL 60601 | COMBINED INSURANCE COMPANY OF AMERICA | $8 | — | $8 | 0.31% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY INC | 2533 SPRING ARBOR RD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 3.49% |
| LAURA ANN MARSHALL3 | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 2.25% |
| TIFFANIE MARIE UNDERWOOD3 | 4601 FELLA STREET SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 TPA | Contract Administrator Service code 13 | — | $418K |
| HEALTH EOS EIN 39-1634080 TPA | Contract Administrator Service code 13 | — | $5K |
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 | 1,344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 72 | $448K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 1,353 | $391K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 1,353 | $391K |
| Life insurance(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,441 | $260K |
| Short-term disability(4 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 8 | $11K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,441 | $249K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 72 | $446K |
| Other(8 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,441 | $421K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,441 | — |
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.