| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | BLUECROSS BLUE SHIELD OF ILLINOIS | $33K | $2K | $35K | 4.25% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | $282 | $8K | 5.12% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $217 | $6K | 4.72% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $8K | 12.35% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 20.43% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $967 | $4K | 19.87% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | VISION SERVICE PLAN | $814 | — | $814 | 6.68% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $35 | — | $35 | 0.29% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $442 | $2K | 20.05% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $382 | $153 | $535 | 14.01% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $169 | $169 | 4.96% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUECROSS BLUE SHIELD OF ILLINOIS | 127 | $1.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $62K |
| Vision | VISION SERVICE PLAN | 74 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 38 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $27K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.