| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $17K | $17K | 1.00% |
| MARK S. PONDER3 | 15469 MIDDLEBELT ROAD LIVONIA, MI 48154 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | $0 | $8K | 0.48% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | PRINCIPLE LIFE INSURANCE COMPANY | $57K | — | $57K | 9.55% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2550 S ROCHESTER ROAD ROCHESTER HILLS, MI 483073817 | PRINCIPLE LIFE INSURANCE COMPANY | $11K | — | $11K | 1.85% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 492217801 | NATIONWIDE LIFE INSURANCE COMPANY | $4K | $942 | $5K | 9.59% |
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | NATIONWIDE LIFE INSURANCE COMPANY | $3K | — | $3K | 6.16% |
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 | 1,123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 240 | $1.8M |
| Dental | PRINCIPLE LIFE INSURANCE COMPANY | 837 | $599K |
| Vision | PRINCIPLE LIFE INSURANCE COMPANY | 837 | $599K |
| Life insurance | PRINCIPLE LIFE INSURANCE COMPANY | 837 | $599K |
| Short-term disability | PRINCIPLE LIFE INSURANCE COMPANY | 837 | $599K |
| Prescription drug | NATIONWIDE LIFE INSURANCE COMPANY | 46 | $56K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 46 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 837 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.