| 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 | $77K | — | $77K | 3.79% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.14% |
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE CARE NETWORK OF MICHIGAN | $29K | — | $29K | 3.74% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.24% |
| ACRISURE LLC3 | 220 SOUTH WALNUT STREET MUNCIE, IN 47305 | GUARDIAN | $16K | — | $16K | 7.00% |
| ACRISURE LLC3 | 215 N. CENTRAL AVENUE SUITE 6 DULUTH, MN 55807 | GUARDIAN | $14K | — | $14K | 6.48% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $7K | $12K | 9.33% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $6K | $11K | 11.90% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 12.24% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 16.83% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.35% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.88% |
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 | 366 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 371 | 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 | 333 | $2.8M |
| Dental | GUARDIAN | 326 | $223K |
| Vision | GUARDIAN | 326 | $223K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $119K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $133K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $96K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 333 | $2.8M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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.