| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRAVIS PORTA3 | 7219 GRAND RIVER RD BRIGHTON, MI 481149300 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $31K | — | $31K | 3.85% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE PORTA BENEFITS | 7219 GRAND RIVER BRIGHTON, MI 481149300 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | — | $9K | 1.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 495469546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $56 | — | $56 | 0.01% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD STE 400 SOUTHFIELD, MI 480768076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8 | — | $8 | 0.00% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE AND PORTA BENEFITS | 7219 GRAND RIVER RD BRIGHTON, MI 48114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 11.96% |
| ACRISURE LLC3 Filed as: ACRISURE DBA KEYSER INSURANCE GROUP | 444 W MICHIGAN AVENUE KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $99 | $31 | $130 | 0.34% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICAS INC | 1250 CAPITAL OF TX HWY S BLDG 11 STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $35 | $35 | 0.09% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE AND PORTA BENEFITS | 7219 GRAND RIVER RD BRIGHTON, MI 48114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 7.70% |
| ACRISURE LLC3 Filed as: ACRISURE DBA KEYSER INSURANCE GROUP | 444 W MICHIGAN AVENUE KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $450 | — | $450 | 2.30% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG 11 STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $17 | $17 | 0.09% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INAURANCE SERVICS INC | 1250 CAPITAL OF TX HWY S BLDG 11 STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $18 | $18 | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 DENMOOR AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $4 | $4 | 0.02% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE AND PORTA BENEFITS | 7219 GRAND RIVER RD BRIGHTON, MI 48114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $634 | — | $634 | 7.24% |
| ACRISURE LLC3 Filed as: ACRISURE DBA KEYSER INSURANCE GROUP | 444 W MICHIGAN AVENUE KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $225 | — | $225 | 2.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $16 | — | $16 | 0.18% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 100 | $808K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 100 | $808K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 100 | $808K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 188 | $38K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 188 | $19K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 100 | $808K |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 188 | $67K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.