| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | CASSIE GOODBAND 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 2.71% |
| ACRISURE LLC3 | CASSIE GOODBAND 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $968 | — | $968 | 0.47% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 5.96% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 11.24% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 20.15% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.55% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA KEYSER INSURANCE | 444 W. MICHIGAN AVENUE KALAMAZOO, MI 49007 | EYEMED | $2K | — | $2K | 8.32% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $717 | $2K | 14.35% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $824 | $824 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 16.86% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $759 | $759 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $773 | $2K | 15.90% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $655 | $655 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $773 | $2K | 15.90% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $655 | $655 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $587 | $2K | 19.72% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $622 | $622 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $850 | $3K | 22.18% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $592 | $592 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $250 | $3K | 22.12% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $678 | $678 | — |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $450 | $450 | — |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | — |
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 | 488 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 633 | $205K |
| Vision(2 contracts, 2 carriers) | EYEMED | 499 | $29K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $95K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 407 | $121K |
| Long-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $53K |
| Other(7 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 633 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.