| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | $41K | — | $41K | 4.76% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | HEALTH ALLIANCE PLAN | $33K | — | $33K | 4.82% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $28K | $5K | $33K | 13.24% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 105094095 | PRINCIPAL LIFE INSURANCE COMPANY | — | $12K | $12K | 4.64% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7K | — | $7K | 6.98% |
| WEB TPA5 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 5.03% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA GRAND RAPIDS, MI 49503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 2.31% |
| IMPACT INTERACTIVE LLC3 Filed as: IMPACT INTERACTIVE | 5400 LAUREL SPRINGS PARKWAY SUWANEE, GA 30024 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 1.29% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | PAN-AMERICAN LIFE INSURANCE COMPANY | $13K | — | $13K | 20.50% |
| ADMINISTRATIVE CONCEPTS INC3 Filed as: ADMINISTRATIVE CONCEPTS, INC. | 400 CAMPUS DR SUITE 300 COLLEGEVILLE, PA 19426 | PAN-AMERICAN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.12% |
| SURETY MARKETING & CONSULTING3 | 246 RIVER OAK DR MT. PLEASANT, SC 29464 | PAN-AMERICAN LIFE INSURANCE COMPANY | $2K | — | $2K | 3.29% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | 97 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $250K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $250K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $250K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $250K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $250K |
| Prescription drug(2 contracts, 2 carriers) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | 97 | $1.5M |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 263 | $408K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.