| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JUSTIN M HANCE3 | 8191 MOORSBRIDGE ROAD PORTAGE, MI 49024 | BLUE CROSS BLUE SHEILD | $13K | $706 | $14K | 2.14% |
| GROTENHUIS3 | P.O. BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHEILD | $7K | — | $7K | 1.07% |
| RAYMOND SACKETT3 | 8191 MOORSBRIDGE ROAD PORTAGE, MI 49024 | BLUE CROSS BLUE SHEILD | $6K | — | $6K | 0.94% |
| SACKETT INSURANCE GROUP3 Filed as: SACKETT INSURANCE GROUP INC. | 8191 MOORSBRIDGE ROAD PORTAGE, MI 490247416 | AMERITAS | $3K | — | $3K | 3.20% |
| SACKETT INSURANCE GROUP3 | 8191 MOORSBRIDGE ROAD PORTAGE, MI 49024 | EYE MED | $1K | — | $1K | 10.89% |
| SACKETT INSURANCE GROUP3 Filed as: SACKETT INSURANCE GROUP, INC. | 8191 MOORSBRIDGE RD PORTAGE, MI 490247416 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $922 | — | $922 | 10.00% |
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 | 274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHEILD | 111 | $638K |
| Dental | AMERITAS | 501 | $101K |
| Vision | EYE MED | 497 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 289 | $9K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 289 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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."
No prospect flags tripped on this filing.