| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID L. COBB3 | 6011 WEST RIVER DRIVE BELMONT, MI 49306 | PRIORITY HEALTH | $26K | — | $26K | 3.01% |
| REBEKAH VANBEEK3 | 2780 44TH STREET SW WYOMING, MI 49519 | PRIORITY HEALTH | $9K | — | $9K | 0.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $10K | $10K | 10.28% |
| GIS OF ILLINOIS3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METLIFE LEGAL PLANS | $108 | $0 | $108 | 11.78% |
| BLUE WATER GROUP AGENCY, LLC3 | 4120 EAST BELTLINE AVENUE SUITE 100 GRAND RAPIDS, MI 49525 | METLIFE LEGAL PLANS | $70 | — | $70 | 7.63% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $46 | $46 | 5.02% |
| INNOVATIVE INSURANCE GROUP LLC3 Filed as: INNOVATIVE INSURANCE ADVISORS LLC | 6011 WEST RIVER ROAD NE, SUITE C BELMONT, MI 49306 | METLIFE LEGAL PLANS | $21 | $0 | $21 | 2.29% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 178 | $880K |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $99K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $99K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $99K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $99K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $99K |
| Prescription drug | PRIORITY HEALTH | 178 | $880K |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.