| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | JAMES ALTON 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $28K | — | $28K | 3.00% |
| ACRISURE LLC3 | JAMES ALTON 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 5.03% |
| ACRISURE LLC3 | JAMES ALTON 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $689 | — | $689 | 1.49% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $5K | 12.43% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $511 | $3K | 7.19% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $629 | $600 | $1K | 3.37% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $439 | $214 | $653 | 1.79% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $5 | $184 | 0.50% |
| CHRISTIE MARIE LEWIS3 | 938 THOMAS DR. JACKSON, MI 49203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | — | $162 | 0.44% |
| TIM WOODARD3 Filed as: TIM J WOODARD | 53 CHARLES STREET HILLSDALE, MI 49242 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | $8 | $115 | 0.32% |
| MELISSA DEVON WRIGHT-HALMON3 Filed as: MELISSA DEVON WRIGHT- HALMON | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 0.29% |
| TIMOTHY JOEL WYNSMA3 | 7651 14TH AVE JENISON, MI 49428 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.10% |
| JEROME MAISANO3 Filed as: JEROME ANGELO MAISANO | 22452 LAKECREST ST SAINT CLAIR SHORES, MI 48081 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.06% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $864 | $5K | 18.49% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $515 | $2K | 13.54% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $741 | — | $741 | 7.56% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $407 | $134 | $541 | 13.29% |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 131 | $930K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 142 | $83K |
| Vision | VISION SERVICE PLAN | 75 | $10K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 121 | $65K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $15K |
| Prescription drug | PRIORITY HEALTH | 131 | $930K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 121 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.