| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA L CLINE3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | — | $20K | 3.76% |
| ACRISURE LLC3 | 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.25% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC - CASSIE GOODBAND | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 4.79% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $611 | $2K | 14.28% |
| ACRISURE LLC5 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 7303 MERCHANT CT LAKEWOOD RANCH, FL 34240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $292 | $292 | 2.05% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $513 | $2K | 19.81% |
| ACRISURE LLC5 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 7303 MERCHANT CT LAKEWOOD RANCH, FL 34240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $274 | $274 | 2.57% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 7303 MERCHANT CT LAKEWOOD RANCH, FL 34240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $456 | $456 | 4.30% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 7303 MERCHANT CT LAKEWOOD RANCH, FL 34240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $828 | — | $828 | 8.84% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $433 | $433 | 4.62% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $113 | $1K | 16.36% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 7303 MERCHANT CT LAKEWOOD RANCH, FL 34240 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $537 | — | $537 | 9.99% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA KEYSER INS GROUP | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $228 | $228 | 4.24% |
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 | 112 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 195 | $543K |
| Dental | DELTA DENTAL OF MICHIGAN | 169 | $52K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $14K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $14K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $11K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 195 | $543K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.