| 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 | $14K | $28K | 1.41% |
| HERMAN H KLINGELHOFER3 Filed as: HERMAN KLINGELHOFER | 638 DETROIT AVE LAKE ORION, MI 48362 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 4.82% |
| STEVEN R. MILLER3 Filed as: STEVEN R MILLER | 89 MONROE CTR NW STE 200 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 14.84% |
| STEVEN R. MILLER3 Filed as: STEVEN R MILLER | 89 MONROE CENTER NW SUITE 200 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $979 | — | $979 | 2.53% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $790 | — | $790 | 2.04% |
| MILLS BENEFIT GROUP LLC3 Filed as: MILLS BENEFIT GROUP, LLC | 1115 TAYLOR SUITE 112 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $618 | — | $618 | 1.60% |
| JEFFREY C WERNER3 | 18096 TRUDY DR SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $365 | — | $365 | 0.94% |
| AG AND ASSOCIATES3 | 2150 ASSOCIATION DRIVE STE 150 OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $245 | — | $245 | 0.63% |
| JEREMY D SAMPSEL3 | 3030 9TH ST 2K KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $231 | — | $231 | 0.60% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE-KEUNING INSURANCE GROUP | 4808 BROADMOR SE GRAND RAPIDS, MI 49512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $197 | — | $197 | 0.51% |
| EDWARD O WALTER3 | 505 CHERRY STREET SE APT #309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $122 | — | $122 | 0.32% |
| SHANNON J. ENDERS3 Filed as: SHANNON J ENDERS | 5797 HARVEY ST STE A MUSKEGON, MI 49444 | CONTINENTAL AMERICAN INSURANCE COMPANY | $73 | — | $73 | 0.19% |
| ERIN GERKE3 Filed as: ERIN M GERKE | 834 LAKEVIEW DRIVE LAKE ODESSA, MI 48849 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.08% |
| JIM M BULLOCK3 | 3715 POWDERHORN DR OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| STEPHANIE L KESSELRING3 | 5415 MORNING VIEW TERRACE BRIGHTON, MI 48114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.03% |
| JAMES C SNIDER JR3 Filed as: JAMES C SNIDER | 830 JUANITA RAEL WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.03% |
| HEIDIE GLAUB3 | 5458 PARKSIDE BRIGHTON, MI 48114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| THOMAS W RINGWALD3 | 2732 SPIRIT ROCK TRAIL RENO, NV 89511 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| HEATHER A DOLLIVER3 | 212 W SILVER LK ROAD FENTON, MI 48430 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| CHRIS D BOULDREY3 | 340 WOOD HILLS DRIVE CONCORD, MI 49237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| HERMAN H KLINGELHOFER3 Filed as: HERMAN H. KLINGELHOFER | 638 DETROIT AVE LAKE ORION, MI 48362 | VISION SERVICE PLAN | $1K | — | $1K | 4.76% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $198 | — | $198 | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $156 | — | $156 | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $143 | — | $143 | 4.99% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $74 | — | $74 | 4.98% |
| HERMAN H KLINGELHOFER3 Filed as: HERMAN H KLINGELHOFFER | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18 | — | $18 | 4.97% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 483622332 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13 | — | $13 | 5.20% |
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 | 195 | 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) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 140 | $2.0M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 347 | $2.2M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 140 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 195 | $67K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 195 | $105K |
| Long-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 195 | $109K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 140 | $2.0M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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.