| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | AETNA HEALTH, INC. | — | $2K | $2K | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 0.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | AETNA LIFE INSURANCE CO. | — | $1K | $1K | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | AETNA LIFE INSURANCE CO. | — | $290 | $290 | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 1375 EAST 9TH STREET 30TH FL CLEVELAND, OH 44114 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 29.03% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BENEFITS INC | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 28.57% |
| ACRISURE LLC3 | 1375 EAST 9TH STREET 30TH FLOOR CLEVELAND, OH 44114 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $587 | — | $587 | 1.57% |
| CGI VOLUNTARY BENEFITS, INC.3 Filed as: CGI VOLUNTARY BFTS INC | 3500 WOODRIDGE ROAD CLEVELAND HEIGHTS, OH 44121 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| ACRISURE LLC3 | ONE CLEVELAND CENTER 30TH FLOOR 1375 EAST 9TH ST CLEVELAND, OH 44114 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 24.37% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM H. HERTZOG | 13700 STATE ROAD NORTH ROYALTON, OH 44133 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $552 | $0 | $552 | 3.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ACRISURE LLC DBA BRITTON-GALLAGHER | 1375 EAST NINTH ST. 30TH FLOOR CLEVELAND, OH 44114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $188 | $0 | $188 | 1.07% |
| WICHERT INSURANCE SERVICES3 Filed as: WICHERT INSURANCE SERVICES INC | 5991 CHANDLER COURT WESTERVILLE, OH 43082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $155 | $0 | $155 | 0.89% |
| PATRICIA HERTZOG3 | 8825 CHAUCER BLVD BROADVIEW HTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $0 | $122 | 0.70% |
| HELEN DIZ-HATTON3 Filed as: HELEN E. MCCREADY | 1767 25TH STREET CUYAHOGA FALLS, OH 44223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 0.47% |
| SHARON SIMPSON MCCLENDON3 Filed as: SHARON M. IGNASIAK | 8427 MUIRLAND DRIVE CLEVELAND, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $0 | $58 | 0.33% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH A. WILLHITE | 3619 1/2 PONCIANA AVENUE AKRON, OH 44319 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.09% |
| DAVID L SMELCER3 Filed as: DAVID LEE SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.03% |
| KATHLEEN BYRNE3 | 7142 ANTHONY LANE PARMA HEIGHTS, OH 44130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.03% |
| ACRISURE LLC3 | 1375 EAST 9TH ST. 30TH FLOOR, STE 3000 CLEVELAND, OH 44114 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 15.00% |
| ACRISURE LLC3 | 1375 E 9TH ST 30TH FLOOR, STE 3000 CLEVELAND, OH 44114 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACRISURE LLC DBA BRITTON-GALLAGHER BROKER | Insurance agents and brokers Service code 22 | 100 OTTAWA AVE SE GRAND RAPIDS, MI 49503 | $70K |
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 | 289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 198 | $250K |
| Dental | AETNA LIFE INSURANCE CO. | 198 | $250K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 290 | $287K |
| Life insurance(3 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 290 | $91K |
| Short-term disability(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 43 | $35K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 290 | $36K |
| Other(3 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 290 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.