| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | — | $28K | 2.88% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $473 | $473 | 0.05% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 6.99% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $681 | $3K | 16.75% |
| LEGACY ADVISORS LLC3 Filed as: LEGACY LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $409 | — | $409 | 2.63% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $582 | $2K | 16.60% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $356 | — | $356 | 2.52% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 25.32% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | — | $260 | 2.52% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 12.25% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $225 | — | $225 | 2.75% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $965 | $337 | $1K | 16.77% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $200 | — | $200 | 2.58% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $832 | — | $832 | 12.18% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $193 | — | $193 | 2.82% |
| ACRISURE LLC3 | 300 S FRONT ST MARQUETTE, MI 49855 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $762 | $268 | $1K | 16.81% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $158 | — | $158 | 2.58% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 160 | $967K |
| Dental | DELTA DENTAL OF MICHIGAN | 183 | $86K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $16K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 23 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 23 | $8K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 62 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.