| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK VANDENBRANDEN3 | 28341 HOOVER WARREN, MI 48093 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $80K | — | $80K | 2.56% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.06% |
| MARK VANDENBRANDEN3 | 28341 HOOVER WARREN, MI 48093 | BLUE CARE NETWORK OF MICHIGAN | $75K | — | $75K | 3.17% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.09% |
| ACRISURE LLC3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $49K | $4K | $53K | 13.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC--MARK VANDENBRANDEN | 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $40K | $1K | $42K | 11.04% |
| ACRISURE LLC3 Filed as: ACRISURE D/B/A ADVANCED INSURANCE | 28341 HOOVER RD WARREN, MI 48093 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $26 | $15K | 20.73% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 5.16% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $128 | $128 | 0.17% |
| ACRISURE LLC3 Filed as: ACRISURE D/B/A ADVANCED INSURANCE | 28341 HOOVER RD WARREN, MI 48093 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $26 | $11K | 24.47% |
| GROUP BENEFITS LTD3 | — | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 6.05% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 122 W PINE ST STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $76 | $76 | 0.17% |
| ACRISURE LLC3 Filed as: ADVANCED INSURANCE/ACRISURE | 2831 HOOVER RD WARREN, MI 48093 | 1-800MD, LLC | $5K | — | $5K | 29.16% |
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 | 621 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 623 | 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 | 493 | $5.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 970 | $378K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 621 | $407K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 621 | $407K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 621 | $407K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 621 | $407K |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 589 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 970 | — |
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.