| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | BLUE CARE NETWORK OF MICHIGAN | $43K | $0 | $43K | 1.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $480 | $7K | 10.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $454 | $10K | 15.75% |
| SHAMROCK BENEFITS LLC3 Filed as: SHAMROCK BENEFITS, LLC | 3941 CRYSTAL WATERS LANE NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 12.77% |
| USI INSURANCE SERVICES LLC3 | 1915 KNAPP STREET OSHKOSH, WI 54902 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.56% |
| WELLS FARGO INSURANCE SERVICES3 | 648 MONROE NW, SUITE 300 GRAND RAPIDS, MI 49503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $113 | $2K | 4.39% |
| TATE ALLEN JESKY3 | 8169 HUNTING COURT GEORGETOWN, MI 49428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $511 | $399 | $910 | 2.56% |
| BRUCE A VAN RYN3 Filed as: BRUCE ALBERT VAN RYN | 3053 RIVERDALE DRIVE GRANDVILLE, MI 49418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | $0 | $80 | 0.22% |
| MARY LOU TAYLOR3 | 2610 WINESAP COURT NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 0.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE | $4K | $0 | $4K | 10.63% |
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 | 649 | 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) | 649 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 649 | $2.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 649 | $0 |
| Vision | NATIONAL GUARDIAN LIFE | 245 | $33K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 414 | $160K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 414 | $100K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 414 | $100K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 649 | $2.3M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 414 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 649 | — |
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.