| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $39K | — | $39K | 2.67% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 4.04% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $994 | — | $994 | 0.74% |
| ACRISURE LLC3 | 25 SICOTTE RD MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.69% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.79% |
| ACRISURE LLC3 | 25 SICOTTE RD MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| 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 | 3.41% |
| ACRISURE LLC3 | 25 SICOTTE RD MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| 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 | 4.85% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $598 | $2K | 23.39% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $386 | $153 | $539 | 7.55% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $464 | $64 | $528 | 7.39% |
| JEREMY SAMPSEL3 | 3030 S 9TH ST KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $250 | $208 | $458 | 6.41% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH STREET JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | — | $174 | 2.44% |
| SUSAN MARIE WEITKAMP3 | 246 FIDDLECREEK RIDGE RD WENTZVILLE, MO 63385 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $10 | $26 | 0.36% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT. SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.32% |
| CORCONRAN & HOYT3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 0.14% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $398 | $2K | 28.99% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $523 | $253 | $776 | 14.54% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $218 | $24 | $242 | 4.54% |
| JEREMY SAMPSEL3 | 3030 S 9TH ST KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $60 | $214 | 4.01% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $60 | $212 | 3.97% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT N JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 1.46% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.43% |
| ACRISURE LLC3 | 25 SICOTTE RD MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $507 | — | $507 | 10.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $254 | $254 | 5.01% |
| ACRISURE LLC3 | 1950 CHURCH ST BAKER CITY, OR 97814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $187 | $187 | 3.69% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT N JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $322 | $142 | $464 | 47.64% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $146 | $90 | $236 | 24.23% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $24 | $84 | 8.62% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $8 | $71 | 7.29% |
| JEREMY SAMPSEL3 | 401 HALL ST SW STE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $19 | $49 | 5.03% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.21% |
| ACRISURE LLC3 | DBA VAST MARQUETTE, MI 49855 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $15 | $38 | — |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $8 | $27 | — |
| SUSAN MARIE WEITKAMP3 | 246 FIDDLECREEK RIDGE RD WENTZVILLE, MO 63385 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | — |
| JEREMY SAMPSEL3 | 401 HALL ST SW STE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | — |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 423 | $1.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 390 | $134K |
| Vision | EYEMED VISION CARE | 329 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 136 | $53K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $23K |
| Other(7 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 423 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.