| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOODBAND, CASSIE3 | PO BOX 50631 KALAMAZOO, MI 49007 | PRIORITY HEALTH | $25K | — | $25K | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC - CASSIE GOODBAND | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | $275 | $3K | 5.15% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $555 | $3K | 12.66% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC5 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $386 | $386 | 1.85% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $408 | $2K | 12.58% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $789 | $789 | 5.00% |
| CASSIE GOODBAND3 | PO BOX 50631 KALAMAZOO, MI 49007 | PRIORITY HEALTH | $584 | — | $584 | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $341 | $2K | 17.45% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $696 | $696 | 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 | $360 | $2K | 17.82% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $638 | $638 | 5.00% |
| ACRISURE LLC5 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $335 | $335 | 2.63% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $901 | $291 | $1K | 11.32% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $526 | $526 | 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 | $877 | $232 | $1K | 12.65% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $439 | $439 | 5.01% |
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 | 133 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | PRIORITY HEALTH | 181 | $633K |
| Dental | DELTA DENTAL OF MICHIGAN | 188 | $58K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 95 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $23K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $16K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.