| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK VANDENBRANDEN | 28341 HOOVER WARREN, MI 48093 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | — | $28K | 4.32% |
| ACRISURE LLC | 100 PASSAIC AVE STE 120 FAIRFIELD, NJ 07004 | OPTIMED HEALTH | $15K | — | $15K | 15.00% |
| ACRISURE LLC | 28341 HOOVER RD WARREN, MI 48093 | AMERITAS LIFE INSURANCE CORP | $7K | — | $7K | 11.68% |
| MARK VANDENBRANDEN | 28341 HOOVER WARREN, MI 48093 | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC | $5K | — | $5K | 8.81% |
| ACRISURE LLC Filed as: ACRISURE LLC DBA | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 18.34% |
| SMITH, THOMAS, CHRISTOPHER | 798 BERRY RD PO BOX 40386 NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.31% |
| ACRISURE LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| ACRISURE LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 13.53% |
| ACRISURE LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $619 | — | $619 | 14.98% |
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 | 141 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 182 | $793K |
| Dental | AMERITAS LIFE INSURANCE CORP | 215 | $57K |
| Vision | AMERITAS LIFE INSURANCE CORP | 215 | $57K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $8K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $8K |
| Other(5 contracts, 2 carriers) | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC | 141 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.