| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $25K | — | $25K | 1.83% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.12% |
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 1.87% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $532 | $532 | 0.10% |
| ACRISURE LLC3 | 500 N WATER ST STE 900 CORPUS CHRISTI, TX 78401 | DELTA DENTAL OF MICHIGAN | $9K | $266 | $9K | 8.33% |
| ACRISURE LLC3 | DETROIT OFFICE 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.50% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.80% |
| ACRISURE LLC3 | DETROIT OFFICE 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 11.33% |
| ACRISURE LLC3 | 1229 SWIFT AVE N KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.56% |
| ACRISURE LLC3 | DETROIT OFFICE 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| ACRISURE LLC3 | 1229 SWIFT AVE N KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $798 | $798 | 3.32% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | EYEMED | $2K | — | $2K | 10.03% |
| ACRISURE LLC3 | DETROIT OFFICE 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $640 | $640 | 3.77% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 283 | $1.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 354 | $112K |
| Vision | EYEMED | 331 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $33K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $32K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 283 | $1.9M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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.