| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2163 UNIVERSITY PARK DR. STE 200 OKEMOS, MI 48864 | STANDARD INSURANCE COMPANY | $11K | — | $11K | 14.57% |
| ACRISURE LLC3 | 2163 UNIVERSITY PARK DR. STE 200 OKEMOS, MI 48864 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 14.65% |
| ACRISURE LLC3 | 20055 SW PACIFIC HWY STE 203 SHERWOOD, OR 97140 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 15.71% |
| ACRISURE LLC3 | 20055 SW PACIFIC HWY STE 203 SHERWOOD, OR 97140 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 4.93% |
| KAMINSKY & ASSOCIATES, INC.3 Filed as: KAMINSKY & ASSOCIATES | 2340 DETROIT AVE., STE.3 MAUMEE, OH 43537 | STANDARD INSURANCE COMPANY | $659 | — | $659 | 2.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 34-1440175 ACRISURE LLC | Insurance agents and brokers; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Insurance brokerage commissions and fees; Other commissions Service code 12 | — | $79K |
| COMMUNINTY INSURANCE COMPANY EIN 34-1440175 IGENIORX INC | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $0 |
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 | 283 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 251 | $516K |
| Dental | COMMUNITY INSURANCE COMPANY | 251 | $516K |
| Vision | STANDARD INSURANCE COMPANY | 250 | $25K |
| Life insurance | STANDARD INSURANCE COMPANY | 283 | $73K |
| Short-term disability | STANDARD INSURANCE COMPANY | 164 | $71K |
| Long-term disability | STANDARD INSURANCE COMPANY | 211 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
No prospect flags tripped on this filing.