| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL, INC. | 206 SOUTH JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | $869 | $12K | 12.90% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE BENEFITS | 206 SOUTH JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | UNION SECURITY INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | UNION SECURITY INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE | PO BOX 1788 GRAND RAPIDS, MI 49501 | AMERICA UNITED LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 6307 84TH STREET SE CALEDONIA, MI 49316 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | -$41 | $4K | 9.97% |
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 | 1,054 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,054 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $39K |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 293 | $178K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $39K |
| Life insurance | AMERICA UNITED LIFE INSURANCE COMPANY | 0 | $54K |
| Short-term disability | AMERICA UNITED LIFE INSURANCE COMPANY | 0 | $54K |
| Other | AMERICA UNITED LIFE INSURANCE COMPANY | 0 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 345 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.