| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DENNIS A CAMPBELL3 | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $71K | $810 | $72K | 3.62% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | — | $11K | 7.02% |
| MMA SERVICE CORP5 | 620 S. CAPITOL AVE LANSING, MI 48933 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8K | $8K | 5.00% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | LIFE INSURANCE COMPANY OF NORTH AMERICA-BASIC LIFE | $10K | — | $10K | 12.00% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | LIFE INSURANCE COMPANY OF NORTH AMERICA-LONG TERM DISABILITY | $11K | — | $11K | 15.00% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | FIDELITY SECURITY LIFE INSURANCE-EYEMED VISION CARE | $3K | — | $3K | 13.02% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48086 | LIFE INSURANCE COMPANY OF NORTH AMERICA-ACCIDENTAL DEATH | $264 | — | $264 | 12.01% |
| ACRISURE LLC3 Filed as: RALPH WILSON AGENCY INC. | 26026 TELEGRAPH RD., SUITE 100 SOUTHFIELD, MI 48033 | FIDELITY SECURITY LIFE INSURANCE-EYEMED VISION CARE COBRA | $17 | — | $17 | 13.28% |
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 | 306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 299 | $2.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 299 | $156K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE-EYEMED VISION CARE | 306 | $20K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA-BASIC LIFE | 174 | $84K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA-LONG TERM DISABILITY | 110 | $70K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA-ACCIDENTAL DEATH | 174 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.