| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JEFFREY A SCHULTZ3 Filed as: JEFFREY SCHULTZ | 16805 W CLEVELAND AVENUE NEW BERLIN, WI 53151 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $36K | — | $36K | 3.02% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.19% |
| JEFFERY SCHULTZ3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | BLUE CARE NETWORK OF MICHIGAN | $13K | — | $13K | 2.76% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | — | $770 | $770 | 0.16% |
| ACRISURE LLC3 | PO BOX 510187 NEW BERLIN, WI 53151 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | — | $16K | 4.63% |
| ACRISURE LLC3 | PO BOX 51187 NEW BERLIN, WI 53151 | WYSSTA INSURANCE COMPANY INC | $4K | — | $4K | 8.11% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 12.52% |
| SHANNON A LADING3 | 738 W FOURTH STREET APPLETON, WI 54914 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 10.07% |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL DESPIRITO | 2892 N HILLCREST DR HORTONVILLE, WI 54944 | CONTINENTAL AMERICAN INSURANCE COMPANY | $366 | — | $366 | 1.16% |
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 | 514 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 522 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 514 | $4.6M |
| Vision | WYSSTA INSURANCE COMPANY INC | 412 | $45K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 1,591 | $346K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 1,591 | $346K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 1,591 | $346K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 288 | $1.6M |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,591 | $381K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,591 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.