| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JEFFREY A LEWIS4 | 940 ELMDALE NE GRAND RAPIDS, MI 495259525 | BLUE CARE NETWORK OF MICHIGAN | $23K | — | $23K | 3.00% |
| JEFFREY A LEWIS4 | 1380 ANNA MUSKEGON, MI 49445 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 5.15% |
| JEFFREY A LEWIS3 | 940 ELMDALE NE GRAND RAPIDS, MI 495259525 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 13.41% |
| ACRISURE LLC5 | 489 SEMINOLE ROAD MUSKEGON, MI 49444 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.02% |
| JEFFREY A LEWIS3 | 940 ELMDALE NE GRAND RAPIDS, MI 495259525 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $474 | — | $474 | 3.22% |
| JEFFREY A LEWIS4 | 940 ELMDALE NE GRAND RAPIDS, MI 495259525 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $882 | — | $882 | 10.00% |
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 | 165 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 163 | $796K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 174 | $72K |
| Vision | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 146 | $9K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 123 | $22K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 163 | $796K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 123 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.