| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 4.58% |
| THE ULTIMATE SOFTWARE GROUP3 Filed as: THE ULTIMATE SOFTWARE GROUP INC | 1485 NORTH PARK DRIVE WESTON, FL 33326 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 5.00% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.17% |
| THE ULTIMATE SOFTWARE GROUP3 Filed as: THE ULTIMATE SOFTWARE GROUP INC | 1485 NORTH PARK DRIVE WESTON, FL 33326 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 5.00% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.65% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 5.05% |
| THE ULTIMATE SOFTWARE GROUP3 Filed as: THE ULTIMATE SOFTWARE GROUP INC | 1485 NORTH PARK DRIVE WESTON, FL 33326 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 5.00% |
| ACRISURE LLC3 | 2150 S CENTRAL EXPY STE 280 MCKINNEY, TX 75070 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN | $8K | — | $8K | 15.03% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| THE ULTIMATE SOFTWARE GROUP3 Filed as: THE ULTIMATE SOFTWARE GROUP INC | 1485 NORTH PARK DRIVE WESTON, FL 33326 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC3 | DBA HNI RISK SERVICES 16805 W. CLEVELAND AVE NEW BERLIN, WI 53151 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $415 | — | $415 | 10.67% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | DBA GROUP BENEFIT CONCEPTS INC 428 NE 17 WAY FORT LAUDERDALE, FL 33301 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $40 | $40 | 1.03% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $283 | — | $283 | 15.00% |
| THE ULTIMATE SOFTWARE GROUP3 Filed as: THE ULTIMATE SOFTWARE GROUP INC | 1485 NORTH PARK DRIVE WESTON, FL 33326 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $94 | $94 | 4.98% |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 39 | $237K |
| Vision | VISION SERVICE PLAN | 247 | $55K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 418 | $123K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 264 | $123K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 418 | $99K |
| Other(5 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 418 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
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.