| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMIE MILLS3 Filed as: C JAMIE MILLS | 1115 TAYLOR AVE., N STE 112 GRAND RAPIDS, MI 49503 | DELTA DENTAL | $22K | — | $22K | 1.90% |
| PRIORITY HEALTH INSURANCE COMPANY5 | — | PRIORITY HEATH INSURANCE COMPANY | — | — | $0 | 0.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE., SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $81K | $13K | $93K | 23.12% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE., SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $44K | $11K | $55K | 22.43% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE., SE GRAND RAPIDS, MI 49512 | VISION SERVICE PLAN | $7K | — | $7K | 3.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE., SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $6K | $9K | 6.37% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE., SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $32K | $7K | $39K | 37.27% |
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 | 2,230 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEATH INSURANCE COMPANY | 4,803 | $1.1M |
| Dental | DELTA DENTAL | 4,912 | $1.2M |
| Vision | VISION SERVICE PLAN | 1,608 | $239K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,151 | $403K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 837 | $105K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,230 | $389K |
| Prescription drug | PRIORITY HEATH INSURANCE COMPANY | 4,803 | $1.1M |
| Stop-loss / reinsurancereinsurance | PRIORITY HEATH INSURANCE COMPANY | 4,803 | $1.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,230 | $547K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,912 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.