| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON NICKEL3 Filed as: JASON D NICKEL | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $22K | — | $22K | 2.19% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 0.41% |
| JASON NICKEL3 Filed as: JASON D NICKEL | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $8K | — | $8K | 2.28% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 0.45% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 9.75% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | HARTFORD LIFE AND ACCIDENT | — | $631 | $631 | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | HARTFORD LIFE AND ACCIDENT | $3 | — | $3 | 0.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $11K | — | $11K | 10.79% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | — | $275 | $275 | 0.26% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC. | 56 GRANDVILLE AVE SW STE 300 GRAND RAPIDS, MI 49503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 MEDICAL PLAN TPA | Contract Administrator Service code 13 | 618 KENMOOR AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | $34K |
| LIGHTHOUSE INSURANCE GROUP AGENT | Insurance agents and brokers; Other commissions; Other fees; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 56 GRANDVILLE AVE SW SUITE 300 GRANDVILLE, MI 49503 | $30K |
| JASON D NICKEL AGENT | Insurance agents and brokers; Non-monetary compensation; Other commissions; Other fees; Insurance brokerage commissions and fees Service code 22 | 56 GRANDVILLE AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | $30K |
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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 222 | $1.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 328 | $105K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 333 | $14K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 162 | $123K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 162 | $123K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 162 | $123K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 222 | $1.4M |
| Stop-loss / reinsurancereinsurance | IMG | 0 | $62K |
| Other | HARTFORD LIFE AND ACCIDENT | 162 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.