| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $35K | — | $35K | 2.95% |
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | — | $14K | 3.12% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $7K | $148 | $7K | 6.76% |
| ACRISURE LLC3 | 500 N WATER ST STE 900 CORPUS CHRISTI, TX 78401 | DELTA DENTAL OF MICHIGAN | $1K | — | $1K | 1.29% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.76% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 17.65% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 20.14% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | EYEMED | $2K | — | $2K | 10.76% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $933 | $2K | 16.01% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 273 | $1.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 372 | $105K |
| Vision | EYEMED | 329 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $30K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 273 | $1.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.