| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBRA VANSWEDEN3 Filed as: DEBRA WRIGHT | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $38K | $0 | $38K | 4.00% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 5.70% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MICHIGAN LLC | UNKNOWN NEW BERLIN, WI 53151 | DELTA DENTAL OF MICHIGAN | $269 | $0 | $269 | 0.44% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | AFLAC | $1K | $0 | $1K | 4.80% |
| MJ INSURANCE3 Filed as: RAY HINKLE AND VARIOUS AGENTS | 6062 ARCHER STREET NE ROCKFORD, MI 49341 | AFLAC | $780 | $99 | $879 | 3.79% |
| MARY EVELYN LEGGETT3 Filed as: MARY LEGGETT | 522 MAPLE STREET ALLEGAN, MI 49010 | AFLAC | $362 | $85 | $447 | 1.93% |
| LISA ENERSON3 | 411 GROVE STREET HUDSON, MI 49247 | AFLAC | $414 | $32 | $446 | 1.92% |
| WILLIAM JOHNSON & ASSOC LLC3 Filed as: WILLIAM JOHNSON & ASSOCIATES LLC | 2922 FULLER AVENUE NE, UNIT 202 GRAND RAPIDS, MI 49505 | AFLAC | $226 | $33 | $259 | 1.12% |
| ROBERT L PARSONS3 Filed as: ROBERT PARSONS | 4000 PORTAGE STREET, SUITE 109 KALAMAZOO, MI 49001 | AFLAC | $180 | $0 | $180 | 0.78% |
| CONNIE RUPERT3 | 518 NORTH EVANS STREET TECUMSEH, MI 49286 | AFLAC | $120 | $8 | $128 | 0.55% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $12 | $2K | 12.43% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SE SUITE 160 GRAND RAPIDS, MI 49546 | METROPOLITAN LIFE INSURANCE COMPANY | $619 | $209 | $828 | 5.76% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NE, SUITE 510 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 9.98% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $84 | $0 | $84 | 0.81% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 263 | $938K |
| Dental | DELTA DENTAL OF MICHIGAN | 215 | $61K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 173 | $10K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 214 | $14K |
| Short-term disability | AFLAC | 36 | $23K |
| Prescription drug | PRIORITY HEALTH | 263 | $938K |
| Other(2 contracts, 2 carriers) | AFLAC | 214 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.