| 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 | 4.00% |
| KURT BUURSMA3 | 460 S WAVERLY ROAD HOLLAND, MI 49423 | KANSAS CITY LIFE | $19K | — | $19K | 11.52% |
| THE BUURSMA AGENCY3 Filed as: BUURSMA AGENCY LLC | 460 S WAVERLY RD HOLLAND, MI 49423 | STARMOUNT LIFE INSURANCE COMPANY | $3K | — | $3K | 25.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KURT A BUURSMA AGENT,BROKER | Insurance agents and brokers Service code 22 | 460 S WAVERLY RD HOLLAND, MI 49423 | $91K |
| BUURSMA AGENCY, LLC AGENT;BROKER | Insurance agents and brokers Service code 22 | 460 S WAVERLY RD HOLLAND, MI 49423 | $3K |
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 | 136 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 125 | $1.8M |
| Dental(2 contracts, 2 carriers) | PRIORITY HEALTH | 136 | $2.0M |
| Vision(3 contracts, 3 carriers) | PRIORITY HEALTH | 136 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | PRIORITY HEALTH | 136 | $2.0M |
| Prescription drug | PRIORITY HEALTH | 125 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.