| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVE M. ROGUS3 | 877 E. 16TH STREET HOLLAND, MI 494221439 | BLUE CARE NETWORK OF MICHIGAN | $25K | — | $25K | 4.71% |
| EVE M. ROGUS3 | 877 E 16TH STREET HOLLAND, MI 494221439 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $16K | — | $16K | 5.38% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE-KEUNING AGENCY | 4808 BROADMOOR SE GRAND RAPIDS, MI 495125306 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $212 | — | $212 | 0.07% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4000 TOWN CTR. STE 800 SOUTHFIELD, MI 48075 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 10.00% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS CO PRESCRIPTION DRUG PLAN | $1K | — | $1K | 8.89% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE-KEUNING INSURANCE | 877 EAST 16TH STREET HOLLAND, MI 49423 | UNITED AMERICAN INS CO PRESCRIPTION DRUG PLAN | $341 | — | $341 | 2.22% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | UNITED AMERICAN INS CO MEDICARE SUPPLEMENT | $1K | — | $1K | 11.76% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE-KEUNING INSURANCE | 877 EAST 16TH STREET HOLLAND, MI 49423 | UNITED AMERICAN INS CO MEDICARE SUPPLEMENT | $533 | — | $533 | 5.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC. | 4000 TOWN CENTER SUITE 800 SOUTHFIELD, MI 48075 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 74.83% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 170 | $838K |
| Vision | VISION SERVICE PLAN INSURANCE COMPANY | 97 | $16K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $56K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 96 | $3K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 170 | $844K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.