| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $30K | $30K | 3.78% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHEAST PR INS SERV LLC- | 5411 SKY CENTER DR STE 600 TAMPA, FL 33607 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $21K | $21K | 2.66% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS | INSURANCE SERVICES, LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | — | $19K | 10.12% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 4.93% |
| ACRISURE LLC3 | 2965 ALT 19 PALM HARBOR, FL 34683 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 3.23% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $818 | $818 | 0.44% |
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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 72 | $787K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $185K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $185K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $185K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $185K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.