| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELAINE ASH3 | 161 OTTAWA NW SUITE 301 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $68K | — | $68K | 4.00% |
| ACRISURE LLC3 | 500 N WATER ST STE 900 CORPUS CHRISTI, TX 78401 | DELTA DENTAL OF MICHIGAN | $5K | $256 | $5K | 4.98% |
| ACRISURE LLC3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | COMPANION LIFE | $6K | — | $6K | 14.31% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PKWY SE GRAND RAPIDS, MI 49546 | COMPANION LIFE | $3K | — | $3K | 6.44% |
| AGENT ALLIANCE CORPORATION3 | 500 CASCADE WEST PKWY SUITE 160 GRAND RAPIDS, MI 49546 | COMPANION LIFE | $371 | — | $371 | 0.83% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | PAUL GOEBEL GROUP INC 161 OTTAWA AVE, NW #301 GRAND RAPIDS, MI 49503 | EYEMED | $2K | — | $2K | 9.28% |
| BENEFIT PROFILES INC3 | 500 CASCADE ROAD #160 GRAND RAPIDS, MI 49546 | EYEMED | $1K | — | $1K | 4.64% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PAUL GOEBEL GROUP | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $374 | $18 | $392 | 12.07% |
| BENEFIT PROFILE INC3 | 500 CASCADE WEST PKWY SE STE 160 GRAND RAPIDS, MI 49546 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $374 | — | $374 | 11.52% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH INSURANCE COMPANY | 353 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 401 | $110K |
| Vision | EYEMED | 405 | $25K |
| Life insurance | COMPANION LIFE | 241 | $45K |
| Other(2 contracts, 2 carriers) | COMPANION LIFE | 241 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 405 | — |
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.