| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | BENEFIT HEALTH ADVISOR 9605 S KINGSTON CT, STE 150 ENGLEWOOD, CO 80112 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $26 | $4K | 17.83% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $869 | — | $869 | 4.42% |
| ACRISURE LLC3 Filed as: ACRISURE NORTHWEST PARTNERS INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITEDHEALTHCARE INSURANCE COMPANY | $864 | — | $864 | 5.51% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA BENEFIT HEALTH ADV | 9605 S KINGSTON CT #150 ENGLEWOOD, CO 80112 | UNITEDHEALTHCARE INSURANCE COMPANY | $709 | — | $709 | 4.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | PO BOX 2158 RIVERSIDE, CA 92516 | HARTFORD LIFE AND ACCIDENT | $325 | — | $325 | 14.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | HARTFORD LIFE AND ACCIDENT | — | $65 | $65 | 3.00% |
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 | 292 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 104 | $16K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 292 | $20K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 7 | $2K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 300 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.