| 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 | $68K | — | $68K | 2.95% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.06% |
| SARAH C HOFFMAN3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE CARE NETWORK OF MICHIGAN | $23K | — | $23K | 2.84% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | — | $816 | $816 | 0.10% |
| ACRISURE LLC3 | 215 N. CENTRAL AVENUE SUITE 6 DULUTH, MN 55807 | GUARDIAN | $14K | — | $14K | 6.63% |
| ACRISURE LLC3 | 220 SOUTH WALNUT STREET MUNCIE, IN 47305 | GUARDIAN | $913 | — | $913 | 0.42% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $9K | $15K | 10.14% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $7K | $12K | 10.75% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $5K | $9K | 12.57% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 16.87% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.17% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 22.04% |
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 | 511 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 514 | 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 | 351 | $3.1M |
| Dental | GUARDIAN | 343 | $217K |
| Vision | GUARDIAN | 343 | $217K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 578 | $138K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 578 | $149K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 578 | $110K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 351 | $3.1M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 578 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 578 | — |
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.