| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R ALTON3 Filed as: JAMES ALTON | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $18K | $652 | $19K | 5.20% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 10.12% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7K | — | $7K | 10.02% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLAZA DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 13.42% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.03% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ACRISURE LLC3 | 1229 SWIFT AVE NORTH KANSAS CITY, MO 64116 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 446 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 1,073 | $362K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 855 | $66K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $141K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 40 | $12K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 85 | $13K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,073 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.