| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEGACY PARTNERS II LLC3 | 31300 PLYMOUTH RD LIVONIA, MI 48150 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 6.88% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS LLLC | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $108 | $108 | 0.32% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | -$294 | -$294 | -0.88% |
| LEGACY ADVISORS LLC3 Filed as: LEGACY LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $145 | $145 | 0.78% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | -$151 | -$151 | -0.81% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $109 | $109 | 0.71% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | -$129 | -$129 | -0.85% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $179 | $179 | 1.65% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $142 | $142 | 1.46% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $76 | $76 | 0.91% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | -$75 | -$75 | -0.89% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $992 | — | $992 | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $60 | $60 | 0.91% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | -$59 | -$59 | -0.89% |
| JAMES R. HAYES3 Filed as: JAMES R HAYES | 31300 PLYMOUTH RD LIVONIA, MI 48150 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | $500 | $7K | — |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | — |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 133 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 228 | $97K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $8K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.