| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $42K | $42K | 3.85% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $4K | $4K | 0.34% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2965 ALTERNATE 19 NORTH PALM HARBOR, FL 346831907 | GUARDIAN | $4K | $6K | $10K | 10.39% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434, STE. 250 LONGWOOD, FL 32750 | GUARDIAN | $643 | — | $643 | 0.68% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 13.76% |
| ACRISURE LLC5 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.31% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PKWY SE STE 600 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $578 | — | $578 | 1.60% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 22.58% |
| ACRISURE LLC5 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.23% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PKWY SE STE 600 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $952 | — | $952 | 3.36% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 21.58% |
| ACRISURE LLC5 Filed as: ACRISURE, LLC | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 493168081 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.48% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PKWY SE STE 600 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $752 | — | $752 | 3.43% |
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 | 274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 225 | $1.1M |
| Dental | GUARDIAN | 160 | $95K |
| Vision | GUARDIAN | 160 | $95K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $28K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $36K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $22K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.