| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVE GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $12K | — | $12K | 5.83% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | PO BOX 955909 SAINT LOUIS, MO 63195 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.06% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 1.63% |
| ACRISURE LLC3 | DBA THE CAMPBELL GROUP 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 5.87% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 4.13% |
| MARTIN INSURANCE GROUP3 Filed as: MARTIN INSURANCE SERVICES, INC | 259 PROSPECT PLAINS ROAD BLDG F STE 110 CRANBURY, NJ 08512 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $327 | $327 | 0.41% |
| ACRISURE LLC3 | DBA THE CAMPBELL GROUP 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.79% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 4.21% |
| MARTIN INSURANCE GROUP3 Filed as: MARTIN INSURANCE SERVICES, INC | 259 PROSPECT PLAINS ROAD BLDG F STE 110 CRANBURY, NJ 08512 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $209 | $209 | 0.42% |
| ACRISURE LLC3 | DBA THE CAMPBELL GROUP 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.22% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.78% |
| MARTIN INSURANCE GROUP3 Filed as: MARTIN INSURANCE SERVICES, INC | 259 PROSPECT PLAINS ROAD BLDG F STE 110 CRANBURY, NJ 08512 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $166 | $166 | 0.44% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $2K | — | $2K | 5.91% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495039503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 8.48% |
| AON CONSULTING INC3 Filed as: AON CONSULTING WORLDWIDE INC | 29840 NETWORK PLACE CHICAGO, IL 606731298 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 6.14% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495039503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 8.96% |
| AON CONSULTING INC3 Filed as: AON CONSULTING WORLDWIDE INC | 29840 NETWORK PLACE CHICAGO, IL 606731298 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $948 | — | $948 | 6.04% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495039503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $850 | — | $850 | 8.73% |
| AON CONSULTING INC3 Filed as: AON CONSULTING WORLDWIDE INC | 29840 NETWORK PLACE CHICAGO, IL 606731298 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $594 | — | $594 | 6.10% |
| ACRISURE LLC3 | DBA THE CAMPBELL GROUP 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $357 | — | $357 | 5.63% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $278 | — | $278 | 4.38% |
| MARTIN INSURANCE GROUP3 Filed as: MARTIN INSURANCE SERVICES, INC | 259 PROSPECT PLAINS ROAD BLDG F STE 110 CRANBURY, NJ 08512 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $26 | $26 | 0.41% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495039503 | HARTFORD LIFE AND ACCIDENT | $341 | $24 | $365 | 16.08% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | HARTFORD LIFE AND ACCIDENT | — | $114 | $114 | 5.02% |
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 | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 575 | $198K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 483 | $37K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 549 | $80K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 138 | $37K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 455 | $50K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 458 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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.