| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAQUEL PAULUS3 | 1368 BUSINESS PARK DRIVE TRAVERSE CITY, MI 49686 | PRIORITY HEALTH | $29K | $0 | $29K | 4.11% |
| HIGH STREET INSURANCE PARTNERS, INC3 Filed as: HIGH STREET INSURANCES SERVICES | 305 WEST FRONT STREET, SUITE 201 TRAVERSE CITY, MI 49684 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 8.83% |
| KIMBERLEE DIEL3 | 5841 DOVER LANE TRAVERSE CITY, MI 49685 | AFLAC | $1K | $0 | $1K | 17.35% |
| CHRISTOPHER J CHARLAND3 Filed as: CHRISTOPHER J. CHARLAND | 1004 LOCUST STREET TRAVERSE CITY, MI 49684 | AFLAC | $314 | $0 | $314 | 5.40% |
| MATTHEW THOMAS NEMODE3 | 815 EAST MIDLAND STREET BAY CITY, MI 48706 | AFLAC | $165 | $0 | $165 | 2.84% |
| HIGH STREET INSURANCE PARTNERS, INC3 Filed as: HIGH ST. INS SVCS GREAT LAKES, INC. | 305 WEST FRONT STREET, SUITE 201 TRAVERSE CITY, MI 49684 | AFLAC | $77 | $0 | $77 | 1.33% |
| MJ INSURANCE3 Filed as: BENJAMIN HUNTER AND VARIOUS AGENTS | 18401 AVEBURY LANE WESTFIELD, IN 46062 | AFLAC | $68 | $0 | $68 | 1.17% |
| MARY K. MOONEY3 | 6300 SOUTH GOOD HARBOR TRAIL CEDAR, MI 49621 | AFLAC | $29 | $0 | $29 | 0.50% |
| JOHN W POMEROY3 Filed as: JOHN W. POMEROY | 8625 REDBARK PASS TRAVERSE CITY, MI 49684 | AFLAC | $18 | $0 | $18 | 0.31% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 157 | $711K |
| Dental(2 contracts, 2 carriers) | AFLAC | 141 | $6K |
| Vision(2 contracts, 2 carriers) | AFLAC | 141 | $6K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $63K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $58K |
| Prescription drug | PRIORITY HEALTH | 157 | $711K |
| Other(3 contracts, 3 carriers) | PRIORITY HEALTH | 157 | $774K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.