| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER ST STE 200 GRAND RAPIDS, MI 495032900 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 1.10% |
| ACTIVIA BENEFIT SERVICES3 | 660 ADA DR SE ADA, MI 493019153 | VISION SERVICE PLAN | $6K | — | $6K | 1.56% |
| ACTIVA BENEFIT SERVICES, LLC5 | 660 ADA DR SE STE 201 ADA, MI 49301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $15K | $15K | 5.00% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER ST STE 200 GRAND RAPIDS, MI 495032900 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 2.04% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER NW SUITE 200 GRAND RAPIDS, MI 49503 | ALLSTATE BENEFITS | $63K | — | $63K | 22.70% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER STE 200 GRAND RAPIDS, MI 495032900 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.09% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER STE 200 GRAND RAPIDS, MI 495032900 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.27% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER NW SUITE 200 GRAND RAPIDS, MI 49503 | ALLSTATE BENEFITS | $258 | — | $258 | 0.29% |
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 | 5,970 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 204 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PRIORITY HEALTH | 3,796 | $1.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 2,966 | $2.2M |
| Vision | VISION SERVICE PLAN | 2,313 | $354K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 5,970 | $766K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,222 | $307K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,716 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,970 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.