| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $17K | — | $17K | 3.35% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | — | $533 | $533 | 0.11% |
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | — | $9K | 3.25% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $193 | $193 | 0.07% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 4.73% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA THE CAMPBELL GROUP | 5664 PRAIRIE CREEK DR. CALEDONIA, MI 49316 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.05% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA THE CAMPBELL GROUP | 5664 PRAIRIE CREEK DR. CALEDONIA, MI 49316 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | VISION SERVICE PLAN | $751 | — | $751 | 7.49% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA THE CAMPBELL GROUP | 5664 PRAIRIE CREEK DR. CALEDONIA, MI 49316 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 19.99% |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 123 | $771K |
| Dental | DELTA DENTAL OF MICHIGAN | 169 | $65K |
| Vision | VISION SERVICE PLAN | 107 | $10K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 31 | $2K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 31 | $4K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 123 | $771K |
| Other(5 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.