| 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 | $37K | — | $37K | 8.59% |
| HARRY M BAXTER III3 | 3940 BAYWOOD DR SE GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $34K | — | $34K | 10.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.46% |
| ASR HEALTH BENEFITS3 | 618 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | TOKIO MARINE HCC LIFE INSURANCE COMPANY | $11K | — | $11K | 10.00% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 2.21% |
| MARY LOU TAYLOR3 | 1038 BOUNDARY BLVD ROTONDA WEST, FL 33947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 1.96% |
| JAMES A SMAARDYK3 Filed as: JAMES M TAYLOR | 1038 BOUNDARY BLVD ROTONDA WEST, FL 33947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.08% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY INC | 2533 SPRING ARBOR RD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 3.51% |
| LAURA ANN MARSHALL3 Filed as: LAURA ANN MCGINNIS | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 2.19% |
| TIFFANIE MARIE UNDERWOOD3 | 51192 SHELBY ROAD SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.66% |
| LAURA ANN MARSHALL3 Filed as: LAURA ANN MCGINNIS | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 9.29% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY, INC | 2533 SPRING ARBOR ROAD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 6.90% |
| TIFFANIE MARIE UNDERWOOD3 | 51192 SHELBY RD SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 1.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 TPA | Contract Administrator Service code 13 | — | $441K |
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 | 1,314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,321 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 55 | $342K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 1,350 | $430K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 1,350 | $430K |
| Life insurance(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,332 | $344K |
| Short-term disability(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 4 | $2K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,332 | $338K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 55 | $342K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,332 | $451K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,350 | — |
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.