| 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 | $52K | — | $52K | 3.10% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS. GROUP INC. | 56 GRANDVILLE AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.15% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | JASON NICKEL 56 GRANDVILLE AVE GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 4.68% |
| LIGHTHOUSE GROUP3 | 56 CESAR E CHAVEZ AVE SW STE 300 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 11.97% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS. GROUP INC. | 56 GRANDVILLE AVE SW STE300 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $345 | $3K | $3K | 5.12% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK STE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.56% |
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 | 218 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 352 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 329 | $90K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 352 | $1.7M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 367 | $58K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 352 | $1.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 367 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.