| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT SETTLE3 | 4000 TOWN CENTER DRIVE, SUITE 800 SOUTHFIELD, MI 48075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $16K | $0 | $16K | 3.20% |
| JAMES MCKINLEY3 | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 0.78% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $445 | $445 | 0.09% |
| SCOTT SETTLE3 | 4000 TOWN CENTER DRIVE, SUITE 800 SOUTHFIELD, MI 48075 | BLUE CARE NETWORK OF MICHIGAN | $11K | $0 | $11K | 2.59% |
| JAMES MCKINLEY3 | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $2K | $0 | $2K | 0.57% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $0 | $716 | $716 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 13.54% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $544 | $2K | $2K | 5.04% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 92 | $929K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $48K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $48K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 92 | $929K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.