2023 Form 5500 filing — Amerisure Mutual Insurance Company Flexible Benefits Program

Plain-English filing summary

According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20241002154740NAL0009085489001) for Amerisure Mutual Insurance Company Flexible Benefits Program, reported by Amerisure Mutual Insurance Company under EIN 38-0829210 and plan number 501. It reports 734 participants. Attached schedules in the loaded dataset include Schedule C (service provider compensation).

Form 5500 2 · 2023

Filing snapshot

Net assets (EOY)Not reported
Participants734
Provider compensation$1.4M5 Schedule C row(s)$1,362,928
Schedules filedSchedule CLoaded schedules
EFAST2 acknowledgement
20241002154740NAL0009085489001
Plan sponsor
Amerisure Mutual Insurance Company
EIN
38-0829210
Plan number
501
Location
Farmington Hills, MI
Received date
not reported in the loaded dataset
2023

Reported financial snapshot

Reported figures as filed, in whole dollars. Only fields the filing reports are shown.

This 2023 filing is loaded, but detailed Schedule H/I financial figures are not present for it in the current loaded dataset. Participant counts and filing identity above are reported; asset and contribution detail comes from the financial schedules where filed.

Reported service provider compensation (Schedule C)

Compensation reported on the 2023 filing
ProviderServiceDirect comp.Indirect comp.
Community Insurance CompanyBENEFIT ADMINISTRATOR$0$838,641
Community Insurance CompanyBENEFIT ADMINISTRATOR$459,860$0
Delta Dental Of MichiganBENEFIT ADMINISTRATOR$31,116$0
Gallagher Benefit Services IncBROKER AGENT$0$20,295
Gallagher Benefit Services, Inc.BROKER AGENT$0$13,016

Related Form 5500 pages