| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $21K | $21K | 3.78% |
| MERITAIN HEALTH3 Filed as: ENROLLMENT SOLUTIONS ADMIN ALLSTATE | 1776 AHL DRIVE JACKSONVILLE, FL 32224 | ALLSTATE BENEFITS | $37K | $0 | $37K | 16.22% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALT 19 PALM HARBOR, FL 34683 | ALLSTATE BENEFITS | $687 | $0 | $687 | 0.34% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 5.20% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.38% |
| ACRISURE LLC3 | 5664 PRARIE CREEK DRIVE SE CALEDONIA, MI 49316 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $19K | $19K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 FSA CLAIM PROCESSOR | Other services; Claims processing Service code 12 | — | $1.6M |
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 | 3,742 | 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) | 3,742 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | EYEMED ON BEHALF OF THE FIFELITY SECURITY LIFE INSURANCE COMPANY | 3,742 | $230K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $253K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $561K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 0 | $2.0M |
| Other(4 contracts, 2 carriers) | ALLSTATE BENEFITS | 1,238 | $681K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,742 | — |
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.