| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON NICKEL | 1115 TAYLOR AVE NORTH, SUITE 112 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $25K | — | $25K | 5.51% |
| JAMES R ALTON3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 2.77% |
| JOHN EUGENE MATTHEW JR3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $6K | — | $6K | 1.82% |
| GROTENHUIS3 | P.O. BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 1.06% |
| ACRISURE LLC3 | 220 SOUTH WALNUT STREET MUNCIE, IN 47305 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 6.16% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP INC | 877 E 16TH STN PO BOX 1439 HOLLAND, MI 49422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $792 | — | $792 | 0.94% |
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 | 227 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 136 | $795K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $85K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 221 | $85K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 136 | $795K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.