| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON NICKEL3 Filed as: JASON D NICKEL | 56 GRANDVILLE AVE. SW SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $32K | — | $32K | 1.78% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS. GROUP INC. | 56 GRANDVILLE AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.11% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVE SW, STE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $4K | $222 | $4K | 5.01% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVE SUITE 300 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 13.11% |
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 | 220 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 387 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 366 | $88K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 387 | $1.8M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $36K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 387 | $1.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.