| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $34K | — | $34K | 1.91% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.12% |
| JAMES R ALTON3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 1.84% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $118 | $118 | 0.11% |
| JAMES R ALTON3 Filed as: JAMES ALTON | ACRISURE LLC 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $9K | $353 | $10K | 17.55% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 12.98% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.62% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.90% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.14% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE | $3K | — | $3K | 9.94% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 | 823 LUBINGTON ST ESCANABA, MI 49829 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $674 | $674 | 3.30% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA GARCEAU INSURANCE | AENCY PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $97 | $3K | 18.78% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA GARCEAU INSURANCE | AGENCY PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $66 | $2K | 18.93% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA GARCEAU INSURANCE | AGENCY PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $57 | $2K | 18.90% |
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 | 263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 405 | $1.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 133 | $56K |
| Vision | EYEMED VISION CARE | 404 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $85K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $20K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 405 | $1.9M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $85K |
| 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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.