| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARRY M BAXTER III3 Filed as: HARRY M BAXTER, III | 4467 CASCADE ROAD SE SUITE 4480 GRAND RAPIDS, MI 49546 | AMERITAS LIFE INSURANCE CORPORATION | $39K | — | $39K | 8.58% |
| HARRY M BAXTER III3 Filed as: HARRY M. BAXTER III | 5075 CASCADE ROAD GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $8K | — | $8K | 1.92% |
| IL PRODUCER3 | 300 EAST RANDOLPH CHICAGO, IL 60601 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $6K | — | $6K | 1.48% |
| HARRY M BAXTER III3 | 5075 CASCADE RD SE, SUITE L GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | — | $31K | 10.41% |
| ASR HEALTH BENEFITS3 | 618 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | TOKIO MARINE HCC 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 | $7K | — | $7K | 14.27% |
| ENROLL FORCE, LLC3 Filed as: ENROLL FORCE LLC | 503 FORREST PARK CT HUNTSVILLE, AL 35806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $511 | — | $511 | 0.98% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 1.83% |
| MARY LOU TAYLOR3 | 1012 SUGARLOAF RESERVE DR. DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 1.61% |
| JAMES A SMAARDYK3 Filed as: JAMES M TAYLOR | 1012 SUGARLOAF RESERVE DR. DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.09% |
| LAURA ANN MARSHALL3 | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 3.80% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY, INC | 2533 SPRING ARBOR ROAD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 3.26% |
| TIFFANIE MARIE UNDERWOOD3 | 4601 FELLA STREET SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.97% |
| AON CONSULTING INC3 | 200 EAST RANDOLPH CHICAGO, IL 60601 | COMBINED INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 0.14% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY INC | 2533 SPRING ARBOR RD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 6.98% |
| LAURA ANN MARSHALL3 | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 4.51% |
| TIFFANIE MARIE UNDERWOOD3 | 51192 SHELBY ROAD SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 2.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 TPA | Contract Administrator Service code 13 | — | $466K |
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 | 1,205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 65 | $426K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 1,390 | $458K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 1,390 | $458K |
| Life insurance(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,357 | $303K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 3 | $3K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,357 | $295K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 65 | $426K |
| Other(8 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,357 | $465K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,390 | — |
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.