| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAQUEL PAULUS3 | 1368 BUSINESS PARK DR TRAVERSE CITY, MI 49686 | PRIORITY HEALTH | $30K | — | $30K | 3.00% |
| RAQUEL PAULUS3 | 1368 BUSINESS PARK DR TRAVERSE CITY, MI 49686 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 4.34% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR & ASSOC. INC | 305 W FRONT ST, SUITE 201 TRAVERSE CITY, MI 49684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.14% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $255 | $93 | $348 | 0.70% |
| AMY W SYLVAIN3 Filed as: AMY WILKINSON SYLVAIN | 7730 HEDRICK RD. HARBOR SPRINGS, MI 49740 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $269 | — | $269 | 0.54% |
| PATRICIA GROGAN3 Filed as: PATRICIA ANN GROGAN | 430 RIVER POINTE PKWY KINGSFORD, MI 49802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $260 | — | $260 | 0.52% |
| MICHAEL EDWARD HOOVER3 | 206 LAKE STREET ELK RAPIDS, MI 49629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $203 | — | $203 | 0.41% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $18 | $131 | 0.26% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFOR, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.20% |
| SHAMROCK BENEFITS LLC3 | 3941 CRYSTAL WATERS LN NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.17% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 3707 ANITA AVE PASADENA, CA 91107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $4 | $17 | 0.03% |
| KENNETH JAMES BOWERY3 | 3090 MAIN ST. #2 MARLETTE, MI 48453 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $4 | $15 | 0.03% |
| MCCAREY INC3 | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.01% |
| PETERSON MCGREGOR & ASSOCIATES INC.3 Filed as: PETERSON, MCGREGOR & ASSOCIATES | 305 W FRONT ST, SUITE 201 TRAVERSE CITY, MI 49684 | VISION SERVICE PLAN | $1K | — | $1K | 5.44% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR & ASSOC. INC | 305 W FRONT ST, SUITE 201 TRAVERSE CITY, MI 49684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $577 | — | $577 | 3.90% |
| MICHAEL EDWARD HOOVER3 | 206 LAKE STREET ELK RAPIDS, MI 49629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.40% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $2 | $48 | 0.32% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.22% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $1 | $29 | 0.20% |
| SHAMROCK BENEFITS LLC3 Filed as: SHAMROCK BENEFITS LIC | 3941 CRYSTAL WATERS LN NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.17% |
| PATRICIA GROGAN3 Filed as: PATRICIA ANN GROGAN | 430 RIVER POINTE PKWY KINGSFORD, MI 49802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.09% |
| GENA LYNNE MOORE3 | 3254 VALLEY LN S COLUMBUS, OH 43231 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| AMY W SYLVAIN3 Filed as: AMY WILKINSON SYLVAIN | 7730 HEDRIK RD. HARBOR SPRINGS, MI 49740 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR & ASSOC. | 305 W FRONT ST. SUITE 201 TRAVERSE CITY, MI 49684 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $875 | $0 | $875 | 16.47% |
| WRIGHT & ASSOCIATES INSURANCE GROUP3 Filed as: WRIGHT ASSOCIATES INSURANCE | 401 W. FRONT ST. TRAVERSE CITY, MI 49686 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $289 | $289 | 5.44% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR & ASSOC. INC | 305 W FRONT ST, SUITE 201 TRAVERSE CITY, MI 49684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 4.24% |
| MICHAEL EDWARD HOOVER3 | 206 LAKE STREET ELK RAPIDS, MI 49629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.31% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST. KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.23% |
| SHAMROCK BENEFITS LLC3 | 3941 CRYSTAL WATERS LN NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.15% |
| JEREMY SAMPSEL3 | 401 HALL ST SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.15% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.15% |
| GENA LYNNE MOORE3 Filed as: GENA LUNNE MOORE | 3254 VALLEY LN S COLUMBUS, OH 43231 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.08% |
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 | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 178 | $1.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 249 | $78K |
| Vision | VISION SERVICE PLAN | 122 | $21K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 202 | $5K |
| Short-term disability(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 37 | $66K |
| Other(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 37 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.