| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 Filed as: JAMES R. ALTON | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $34K | $0 | $34K | 4.56% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW, SUITE 101 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $4K | $0 | $4K | 0.60% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $0 | $944 | $944 | 0.13% |
| JAMES R ALTON3 Filed as: JAMES R. ALTON | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | $0 | $3K | 7.81% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW, SUITE 101 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $223 | $0 | $223 | 0.59% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 13900 SOUTH WEST BAY SHORE DRIVE TRAVERSE CITY, MI 49684 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.20% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 823 LUBINGTON STREET ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $829 | $829 | 3.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $325 | $0 | $325 | 1.20% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 63097 84TH STREET SE CALEDONIA, MI 49316 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 9.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $171 | $0 | $171 | 0.99% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 19501 | EYEMED VISION CARE OF BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $555 | $0 | $555 | 9.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | EYEMED VISION CARE OF BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $51 | $0 | $51 | 0.84% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 161 | $781K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 137 | $38K |
| Vision | EYEMED VISION CARE OF BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 97 | $6K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $27K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 161 | $781K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 122 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.