| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | JAMES ALTON 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $26K | — | $26K | 3.03% |
| ACRISURE LLC3 | JAMES ALTON 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 5.98% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $529 | $3K | 8.59% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $201 | $2K | 4.72% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | $63 | $411 | 1.20% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $232 | $3 | $235 | 0.69% |
| SUSAN MARIE WEITKAMP3 | 246 FIDDLECREEK RIDGE RD WENTZVILLE, MO 63385 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $58 | $152 | 0.44% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.24% |
| CHRISTOPHER MCRAY3 | 1515 CAPRICE DR JENISON, MI 49428 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $31 | $82 | 0.24% |
| JEROME MAISANO3 Filed as: JEROME ANGELO MAISANO | 22452 LAKECREST ST SAINT CLAIR SHORES, MI 48081 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MELISSA DEVON WRIGHT-HALMON3 Filed as: MELISSA DEVON WRIGHT- HALMON | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $740 | $4K | 18.01% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $408 | $2K | 13.15% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $635 | — | $635 | 6.93% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PARTNER INSURA | 223 W GRAND RIVER AVE #1 HOWELL, MI 48843 | VISION SERVICE PLAN | $146 | — | $146 | 1.59% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $395 | $120 | $515 | 13.04% |
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 | 120 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 130 | $853K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 127 | $80K |
| Vision | VISION SERVICE PLAN | 73 | $9K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 122 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 57 | $13K |
| Prescription drug | PRIORITY HEALTH | 130 | $853K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 122 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.