| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $133K | — | $133K | 3.84% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 0.12% |
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE CARE NETWORK OF MICHIGAN | $38K | — | $38K | 3.74% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | — | $1K | $1K | 0.13% |
| ACRISURE LLC3 | PO BOX 2038 GLENVIEW, IL 60025 | GUARDIAN | $20K | — | $20K | 6.81% |
| ACRISURE LLC3 Filed as: ACRISURE NJ PARTNERS INSURANCE SERV | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | GUARDIAN | — | $10K | $10K | 3.46% |
| ACRISURE LLC3 | 1019 WEST JACKSON STREET MUNCIE, IN 47305 | GUARDIAN | $944 | — | $944 | 0.32% |
| ACRISURE LLC3 Filed as: ACRISURE GREAT LAKES PARTNERS INSUR | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | GUARDIAN | — | $263 | $263 | 0.09% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $6K | $12K | 5.50% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $10K | 5.59% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $9K | 7.10% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $11K | 12.45% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $861 | $6K | 17.45% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $847 | $6K | 17.58% |
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 | 460 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 447 | $4.5M |
| Dental | GUARDIAN | 395 | $293K |
| Vision | GUARDIAN | 395 | $293K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $208K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $222K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $183K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 447 | $4.5M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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."
No prospect flags tripped on this filing.