| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON NICKEL3 Filed as: JASON D. NICKEL | 4808 BROADMOOR, SE GRAND RAPIDS, MI 495125306 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $21K | $35K | 1.60% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 56 GRANDVILLE AVE SW #300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.10% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 4808 BROADMOOR AVENUE, SW GRAND RAPIDS, MI 495125306 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 5.95% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 4808 BROADMOOR, SE GRAND RAPIDS, MI 495125306 | VISION SERVICE PLAN | $1K | — | $1K | 4.85% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 56 GRANDVILLE AVE SW #300 GRAND RAPIDS, MI 495034078 | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 56 GRANDVILLE AVE SW #300 GRAND RAPIDS, MI 49503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $3K | $5K | 24.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Float revenue; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Insurance services; Contract Administrator Service code 12 | — | $203K |
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 | 246 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 246 | $2.2M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 282 | $252K |
| Vision | VISION SERVICE PLAN | 199 | $24K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 282 | $252K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 282 | $252K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 282 | $252K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.