| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BELL-ANDERSON AGENCY INC3 | SHORTEN, KRYSIA R PO BOX 1788 GRAND RAPIDS, MI 49501 | REGENCE BLUESHIELD | $33K | — | $33K | 3.01% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY, INC | ATTN KATHY WATSON 600 SW 39TH ST STE 200 RENTON, WA 98057 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $1K | $11K | 8.05% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 4.08% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $591 | $591 | 0.43% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL-ANDERSON AGENCY | ATTN WEST II CST GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN | $778 | — | $778 | 7.00% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $448 | — | $448 | 4.03% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | TELADOC | $183 | — | $183 | 1.84% |
| GHB INC3 Filed as: GHB INSURANCE | PO BOX 1608 OLYMPIA, WA 98507 | FIRST CHOICE HEALTH PLAN | $144 | — | $144 | 11.63% |
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 | 79 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 79 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUESHIELD | 184 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $138K |
| Vision | VISION SERVICE PLAN | 103 | $11K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $138K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.