| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 1.39% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 5.95% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE MIDWEST PARTNERS | INSURANCE SERVICES LLC PO BOX 510187 NEW BERLIN, WI 53151 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 2.05% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 2.00% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 W CLEVELAND AVENUE NEW BERLIN, WI 53151 | RELIANCESTANDARD | $4K | — | $4K | 15.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCESTANDARD | $1K | $486 | $2K | 6.62% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 W CLEVELAND AVENUE NEW BERLIN, WI 53151 | RELIANCESTANDARD | $4K | — | $4K | 15.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCESTANDARD | $1K | $494 | $2K | 6.68% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 W CLEVELAND AVENUE NEW BERLIN, WI 53151 | RELIANCESTANDARD | $3K | — | $3K | 13.46% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | RELIANCESTANDARD | $1K | $332 | $1K | 6.54% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICA INSURANCE COMPANY | $562 | — | $562 | 3.58% |
| KENNETH STARK3 Filed as: KENNETH R STARK | 1840 COOKE CANYON DR ALBUQUERQEUE, NM 87120 | CONTINENTAL AMERICA INSURANCE COMPANY | $462 | — | $462 | 2.94% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICA INSURANCE COMPANY | $311 | — | $311 | 1.98% |
| KENNETH J HOFFMAN3 Filed as: KENNETH JOHN HOFFMAN | N65 W13544 COBBLESTONE CT, WI 53051 | CONTINENTAL AMERICA INSURANCE COMPANY | $155 | — | $155 | 0.99% |
| MORGAN E MARKOWSKI3 Filed as: MORGAN ELIZABETH MARKOWSKI | 1616 S 167TH ST NEW BERLIN, WI 53151 | CONTINENTAL AMERICA INSURANCE COMPANY | $147 | — | $147 | 0.94% |
| JACK D BREES3 Filed as: JACK DANIEL BREES | 2989 S WAUKESHA RD MILWAUKEE, WI 53227 | CONTINENTAL AMERICA INSURANCE COMPANY | $88 | — | $88 | 0.56% |
| KENNETH STARK3 Filed as: KENNETH R STARK | 1840 COOKE CANYON DR ALBUQUERQEUE, NM 87120 | CONTINENTAL AMERICA INSURANCE COMPANY | $58 | — | $58 | 0.37% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN | $916 | — | $916 | 6.23% |
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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 22 | $242K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 139 | $88K |
| Vision | VISION SERVICE PLAN | 103 | $15K |
| Life insurance | RELIANCESTANDARD | 196 | $29K |
| Short-term disability | RELIANCESTANDARD | 75 | $30K |
| Long-term disability | RELIANCESTANDARD | 79 | $22K |
| Other(2 contracts, 2 carriers) | RELIANCESTANDARD | 196 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.