| 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 | 8.56% |
| HARRY M BAXTER III3 | 3940 BAYWOOD DR SE GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 10.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.50% |
| ASR HEALTH BENEFITS3 | 618 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | TOKIO MARINE HCC LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| BAXTER, HARRY, MURVIN3 | 5075 CASCADE RD SE STE L GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 32.37% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $371 | — | $371 | 0.46% |
| ENROLL FORCE, LLC3 | 503 FORREST PARK CT HUNTSVILLE, AL 35806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.00% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 1.72% |
| MARY LOU TAYLOR3 | 11176 WILLMINGTON BLVD ENGLEWOOD, FL 34224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 1.52% |
| LAURA ANN MARSHALL3 Filed as: LAURA ANN MCGINNIS | 8232 ECKERT RD CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 2.11% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY INC | 2533 SPRING ARBOR RD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 1.78% |
| LAURA ANN MARSHALL3 Filed as: LAURA ANN MCGINNIS | 8232 ECKERT RD. CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 2.99% |
| THE CRAFT AGENCY INC.3 Filed as: THE CRAFT AGENCY, INC | 2533 SPRING ARBOR ROAD JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 1.84% |
| TIFFANIE MARIE UNDERWOOD3 | 51192 SHELBY RD SHELBY TOWNSHIP, MI 48316 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 TPA | Contract Administrator Service code 13 | — | $451K |
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 | 1,445 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 55 | $358K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 1,458 | $432K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 1,458 | $432K |
| Life insurance(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,349 | $351K |
| Short-term disability(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 3 | $2K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,349 | $345K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 55 | $358K |
| Other(7 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,349 | $533K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,458 | — |
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.