| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIAN SACKETT3 Filed as: BRIAN D SACKETT | 8191 MOORBRIDGE RD PORTAGE, MI 49024 | BLUE SHIELD BLUE CROSS OF MICHIGAN | $35K | $874 | $35K | 2.64% |
| SACKETT INSURANCE GROUP3 Filed as: SACKETT AGENCY | 8191 MOORSBRIDGE RD PORTAGE, MI 49024 | BLUE SHIELD BLUE CROSS OF MICHIGAN | — | $678 | $678 | 0.05% |
| SACKETT INSURANCE GROUP3 Filed as: SACKETT INSURANCE GROUP, INC. | 8191 MORRSBRIDGE RD PORTAGE, MI 49024 | NATIONAL GUARDIAN LIFE | $4K | — | $4K | 3.03% |
| SACKETT INSURANCE GROUP3 Filed as: SACKETT INSURANCE GROUP, INC. | 8191 MOORBRIDGE RD PORTAGE, MI 49024 | NATIONAL GUARDIAN LIFE | $2K | — | $2K | 1.33% |
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 | 266 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD BLUE CROSS OF MICHIGAN | 219 | $1.3M |
| Dental | NATIONAL GUARDIAN LIFE | 300 | $121K |
| Vision | NATIONAL GUARDIAN LIFE | 300 | $121K |
| Long-term disability | BLUE SHIELD BLUE CROSS OF MICHIGAN | 219 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.