| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | — | $26K | 1.61% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.12% |
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | BLUE CARE NETWORK OF MICHIGAN | $12K | — | $12K | 1.62% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | — | $3K | $3K | 0.47% |
| ACRISURE LLC3 | 220 SOUTH WALNUT STREET MUNCIE, IN 47305 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $2K | $16K | 8.08% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 9.29% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 9.37% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 11.89% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.18% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $573 | $3K | 19.30% |
| ACRISURE LLC3 | 2176 CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $486 | $2K | 19.02% |
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 399 | 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 | 308 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 321 | $197K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 321 | $197K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 472 | $80K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 472 | $91K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 472 | $84K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 308 | $2.3M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 472 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.