| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 7 SOUTH WARREN STREET DOVER, NJ 07801 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $65K | $65K | 4.50% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA HENRY O. BAKER IN | 100 OTTAWA AVENUE SOUTHWEST GRAND RAPIDS, MI 49506 | AETNA LIFE INSURANCE CO. | $1K | — | $1K | 9.73% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HENRY O BAKER INSU | 7 SOUTH WARREN STREET DOVER, NJ 07801 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 44.00% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49315 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $767 | — | $767 | 9.98% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $28 | $28 | 0.36% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 116 | $1.4M |
| Vision | AETNA LIFE INSURANCE CO. | 154 | $13K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 117 | $9K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 172 | $12K |
| Other(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 177 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.