| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KURT BUURSMA3 Filed as: KURT A. BUURSMA | 238 HOOVER BOULEVARD, SUITE 10 HOLLAND, MI 49423 | PRIORITY HEALTH | $18K | $0 | $18K | 2.34% |
| ROXANNA DIETERLE3 | 300 OTTAWA GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $10K | $0 | $10K | 1.33% |
| DOUGLAS L DERKS3 Filed as: DOUGLAS DERKS | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PRIORITY HEALTH | $2K | $0 | $2K | 0.33% |
| KURT BUURSMA3 Filed as: KURT A. BUURSMA | 238 HOOVER BOULEVARD, SUITE 10 HOLLAND, MI 49423 | PRIORITY HEALTH INSURANCE COMPANY | $4K | $0 | $4K | 2.41% |
| ROXANNA DIETERLE3 | 300 OTTAWA GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 1.22% |
| DOUGLAS L DERKS3 Filed as: DOUGLAS DERKS | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PRIORITY HEALTH INSURANCE COMPANY | $667 | $0 | $667 | 0.37% |
| THE BUURSMA AGENCY3 Filed as: BUURSMA AGENCY, LLC | 238 HOOVER BOULEVARD, SUITE 10 HOLLAND, MI 49423 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 5.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 3.83% |
| BENEFIT PROFILES INC3 Filed as: BENEFIT PROFILES, INC. | 500 CASCADE WEST PARKWAY SE SUITE 160 GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $3K | $233 | $3K | 2.97% |
| ROXANNA DIETERLE3 | 300 OTTAWA NW, SUITE 300 GRAND RAPIDS, MI 49503 | KANSAS CITY LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.19% |
| KURT BUURSMA3 | 238 HOOVER BOULEVARD, SUITE 10 HOLLAND, MI 49423 | KANSAS CITY LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.93% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 198 | $932K |
| Dental | DELTA DENTAL OF MICHIGAN | 257 | $109K |
| Vision | VISION SERVICE PLAN | 79 | $9K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 126 | $58K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 126 | $58K |
| Long-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 126 | $58K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 198 | $932K |
| Other | KANSAS CITY LIFE INSURANCE COMPANY | 126 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.