| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HERMAN H KLINGELHOFER3 | 638 DETROIT LAKE ORION, MI 48362 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $17K | $32K | 1.39% |
| HERMAN H KLINGELHOFER3 Filed as: HERMAN KLINGELHOFER | 638 DETROIT AVE LAKE ORION, MI 48362 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.36% |
| STEVEN R. MILLER3 Filed as: STEVEN R MILLER | 15 IONIA SW STE 350 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 14.98% |
| MILLS BENEFIT GROUP LLC3 Filed as: MILLS BENEFIT GROUP, LLC | 1115 TAYLOR SUITE 112 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 6.70% |
| STEVEN R. MILLER3 Filed as: STEVEN R MILLER | 1115 TAYLOR AVE N STE 112 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.45% |
| CORE DESIGN LLC3 Filed as: CORE DESIGN, LLC | 18080 SANDY OAK TRAIL CEDAR SPRING, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $888 | — | $888 | 1.94% |
| JEREMY D SAMPSEL3 | 3030 9TH ST 2K KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $543 | — | $543 | 1.19% |
| AG AND ASSOCIATES3 | 2150 ASSOCIATION DRIVE STE 150 OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $425 | — | $425 | 0.93% |
| JEFFREY C WERNER3 | 18096 TRUDY DR SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $419 | — | $419 | 0.92% |
| EDWARD O WALTER3 | 505 CHERRY STREET SE APT #309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $330 | — | $330 | 0.72% |
| SHANNON J. ENDERS3 Filed as: SHANNON J ENDERS | 5797 HARVEY ST STE A MUSKEGON, MI 49444 | CONTINENTAL AMERICAN INSURANCE COMPANY | $86 | — | $86 | 0.19% |
| STEPHANIE L KESSELRING3 | 5415 MORNING VIEW TERRACE BRIGHTON, MI 48114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $49 | — | $49 | 0.11% |
| HEATHER A DOLLIVER3 | 212 W SILVER LK ROAD FENTON, MI 48430 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.06% |
| JIM M BULLOCK3 | 3715 POWDERHORN DR OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| JAMES C SNIDER JR3 Filed as: JAMES C SNIDER | 830 JUANITA RAEL WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| HEIDIE GLAUB3 | 5458 PARKSIDE BRIGHTON, MI 48114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| THOMAS W RINGWALD3 | 2732 SPIRIT ROCK TRAIL RENO, NV 89511 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| CHRIS D BOULDREY3 | 340 WOOD HILLS DRIVE CONCORD, MI 49237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| HERMAN H KLINGELHOFER3 Filed as: HERMAN H. KLINGELHOFER | 638 DETROIT AVE LAKE ORION, MI 48362 | VISION SERVICE PLAN | $1K | — | $1K | 4.58% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 164 | $2.3M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 387 | $2.5M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 165 | $2.3M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 239 | $73K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 239 | $119K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 239 | $119K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 164 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.