| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KURT BUURSMA3 Filed as: KURT A BUURSMA | 460 S WAVERLY RD HOLLAND, MI 49423 | PRIORITY HEALTH | $72K | — | $72K | 4.75% |
| KURT BUURSMA3 | 460 S WAVERLY RD HOLLAND, MI 49423 | KANSAS CITY LIFE INSURANCE COMPANY | $17K | — | $17K | 11.48% |
| UMR, INC.5 Filed as: UNITED HEALTHCARE SERVICES INC. | — | ALL SAVERS INSURANCE COMPANY | — | $25K | $25K | 24.72% |
| THE VAN DYKE GROUP3 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | ALL SAVERS INSURANCE COMPANY | $6K | — | $6K | 6.51% |
| THE VAN DYKE GROUP3 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | DEARBORN NATIONAL | $8K | — | $8K | 10.97% |
| THE VAN DYKE GROUP3 Filed as: THE VAN DYKE GROUP, INC. | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | DEARBORN LIFE INSURANCE COMPANY | $6K | — | $6K | 12.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 9.55% |
| THE VAN DYKE GROUP3 | 15915 CRYSTAL CREEK DR, SUITE H HOMER GLEN, IL 60491 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $942 | — | $942 | 3.39% |
| SCOTT KUGLER3 | 1506 W TROY ST FERNDALE, MI 48220 | STARMOUNT LIFE INSURANCE COMPANY | $1K | — | $1K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 5 | Claims processing Service code 12 | 150 W WAUSAU AVE WAUSAU, WI 54401 | $369K |
| GALLAGHER BENEFIT SERVICES INC. EIN 36-4291971 3 | Other commissions Service code 55 | PO BOX 95287 CHICAGO, IL 60694 | $61K |
| THE VAN DYKE GROUP EIN 36-4025371 3 | Other commissions Service code 55 | 15915 S CRYSTAL TREE DR, SUITE H HOMER GLEN, IL 60491 | $21K |
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 443 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 123 | $1.6M |
| Dental(4 contracts, 4 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 219 | $293K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 93 | $11K |
| Life insurance(4 contracts, 4 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 219 | $293K |
| Short-term disability(3 contracts, 3 carriers) | DEARBORN NATIONAL | 219 | $149K |
| Long-term disability(3 contracts, 3 carriers) | DEARBORN NATIONAL | 219 | $149K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 123 | $1.6M |
| Stop-loss / reinsurancereinsurance(3 contracts, 2 carriers) | QBE INSURANCE CORPORATION | 175 | $1.0M |
| Other(2 contracts) | TOKIO MARINE | 175 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.