| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | PRIORITY HEALTH INSURANCE COMPANY | $40K | $0 | $40K | 2.00% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | PRIORITY HEALTH | $39K | $0 | $39K | 2.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MICHIGAN | $8K | $0 | $8K | 2.82% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 14.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 14.38% |
| DAVID E. SHILLING3 | 816 EAST GRANT STREET HASTING, MI 49058 | CONTINENTAL AMERICAN INSURANCE COMPANY | $709 | $0 | $709 | 3.67% |
| BRUCE A VAN RYN3 Filed as: BRUCE A. VAN RYN | 3053 RIVERVAL EAST DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $660 | $0 | $660 | 3.41% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 50 LOUIS STREET NW, SUITE 200 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $636 | $0 | $636 | 3.29% |
| JEREMY SAMPSEL3 Filed as: JEREMY D. SAMPSEL AND OTHER AGENTS | 3030 9TH STREET, SUITE 2K KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $195 | $0 | $195 | 1.01% |
| ERIC J CONDRON3 Filed as: ERIC J. CONDRON | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $194 | $0 | $194 | 1.00% |
| AG AND ASSOCIATES3 Filed as: A.G. AND ASSOCIATES | 2150 ASSOCIATION DRIVE, SUITE 150 OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $150 | $0 | $150 | 0.78% |
| JEFFREY C WERNER3 Filed as: JEFFREY C. WERNER | 18096 TRUDY DRIVE SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $137 | $0 | $137 | 0.71% |
| DAVID E. SHILLING3 Filed as: DAVID SHILLING | 816 EAST GRANT STREET HASTINGS, MI 49058 | AFLAC | $449 | $0 | $449 | 4.86% |
| BENEFIT INNOVATIONS LLP3 Filed as: BENEFIT INNOVATIONS LLC | 4920 SOUTH OJIBWE POINT MEWAYGO, MI 49337 | AFLAC | $296 | $0 | $296 | 3.20% |
| ERIC J CONDRON3 Filed as: ERIC CONDRON | 11358 WILD POND DRIVE SE ROCKFORD, MI 49341 | AFLAC | $162 | $0 | $162 | 1.75% |
| AG AND ASSOCIATES3 Filed as: A.G. AND ASSOCIATES | 6155 GRAEBEAR TRAIL EAST LANSING, MI 48823 | AFLAC | $26 | $0 | $26 | 0.28% |
| RANDALL D LADNER3 Filed as: RANDALL KIMBLER | PO BOX 302 HESPERIA, MI 49421 | AFLAC | $9 | $0 | $9 | 0.10% |
| HEIDI E GLAUB3 Filed as: HEIDI GLAUB | 1325 OAK HOLLOW DRIVE MILFORD, MI 48380 | AFLAC | $9 | $0 | $9 | 0.10% |
| MJ INSURANCE3 Filed as: THOMAS RINGWALD AND VARIOUS AGENTS | 37231 NORTH 110TH STREET SCOTTSDALE, AZ 85262 | AFLAC | $2 | $0 | $2 | 0.02% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 4.30% |
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 | 479 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 524 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH INSURANCE COMPANY | 410 | $3.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 817 | $280K |
| Vision | VISION SERVICE PLAN | 276 | $46K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 478 | $333K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 478 | $333K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 478 | $333K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH INSURANCE COMPANY | 410 | $3.9M |
| Other(6 contracts, 6 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 478 | $400K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 817 | — |
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.