| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SARAH C HOFFMAN3 | 100 OTTAWA AVE GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $11K | — | $11K | 1.96% |
| JAMES R ALTON3 Filed as: JAMES ALTON | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $6K | — | $6K | 1.04% |
| SARAH C HOFFMAN3 | 100 OTTAWA AVE GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $9K | — | $9K | 2.05% |
| JAMES R ALTON3 Filed as: JAMES ALTON | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $4K | — | $4K | 0.95% |
| SARAH C HOFFMAN3 | 100 OTTAWA AVE GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $3K | — | $3K | 2.01% |
| JAMES R ALTON3 Filed as: JAMES ALTON | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $1K | — | $1K | 0.98% |
| SARAH C HOFFMAN3 | 100 OTTAWA AVE GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $3K | — | $3K | 2.03% |
| JAMES R ALTON3 Filed as: JAMES ALTON | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRIORITY HEALTH | $1K | — | $1K | 0.97% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $9K | — | $9K | 7.26% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $524 | $3K | 7.86% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $808 | — | $808 | 1.90% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $358 | $3K | 7.78% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.33% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $426 | $3K | 11.74% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.72% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE | $1K | — | $1K | 8.43% |
| ACRISURE LLC3 | 2163 UNIVERSITY PARK DRIVE OKEMOS, MI 48864 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $244 | $68 | $312 | 5.69% |
| JEREMY SAMPSEL3 | 3030 S 9TH ST KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $75 | $177 | 3.23% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $57 | $143 | 2.61% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $11 | $96 | 1.75% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT. SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.42% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $3 | $10 | 0.18% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.11% |
| DENA ANN MARTHA3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.09% |
| ACRISURE LLC3 | 2176 E CENTRE AVE PORTAGE, MI 49002 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $362 | $62 | $424 | 7.83% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $271 | $271 | 5.00% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $179 | — | $179 | 3.31% |
| ACRISURE LLC3 | 2153 UNIVERSITY PARK DRIVE OKEMOS, MI 48864 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $337 | $87 | $424 | 8.59% |
| JEREMY SAMPSEL3 | 3030 S 9TH ST KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $74 | $276 | 5.59% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $58 | $212 | 4.29% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT N JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $17 | $143 | 2.90% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.55% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $4 | $15 | 0.30% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $2 | $8 | 0.16% |
| DENA ANN MARTHA3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| ACRISURE LLC3 | 2163 UNIVERSITY PARK DRIVE OKEMOS, MI 48864 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 4.42% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 1.08% |
| JEREMY SAMPSEL3 | 3030 S 9TH ST KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.51% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.31% |
| ACRISURE LLC3 | 2163 UNIVERSITY PARK DRIVE OKEMOS, MI 48864 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $18 | $54 | 19.71% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $16 | $32 | 11.68% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $3 | $26 | 9.49% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $11 | $24 | 8.76% |
| DENA ANN MARTHA3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 1.09% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 1.09% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.36% |
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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | PRIORITY HEALTH | 180 | $1.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 322 | $124K |
| Vision | EYEMED VISION CARE | 240 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 111 | $43K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $32K |
| Other(6 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.