| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL P BROOKS3 Filed as: DANIEL BROOKS | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PRIORITY HEALTH | $29K | $0 | $29K | 1.54% |
| ROBERT L. HUGHES3 | 89 MONROW CENTER NW, SUITE 200 GRAND RAPIDS, MI 60143 | PRIORITY HEALTH | $9K | $0 | $9K | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 2.18% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 1 IONIA AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | NATIONWIDE LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.36% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 89 MONROE CENTER NW, SUITE 200 GRAND RAPIDS, MI 49503 | NATIONWIDE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.54% |
| ACRISURE LLC3 | 9500 SOUTH DADELAND BOULEVARD SUITE 400 MIAMI, FL 33156 | NATIONWIDE LIFE INSURANCE COMPANY | -$23 | $0 | -$23 | -0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE, INC. | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.92% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 89 MONROE CENTER NW, SUITE 200 GRAND RAPIDS, MI 49503 | STARMOUNT LIFE INSURANCE COMPANY | $680 | $0 | $680 | 3.14% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 363 | $1.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 361 | $141K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 191 | $22K |
| Life insurance | NATIONWIDE LIFE INSURANCE COMPANY | 199 | $77K |
| Short-term disability | NATIONWIDE LIFE INSURANCE COMPANY | 199 | $77K |
| Long-term disability | NATIONWIDE LIFE INSURANCE COMPANY | 199 | $77K |
| Prescription drug | PRIORITY HEALTH | 363 | $1.9M |
| Other | NATIONWIDE LIFE INSURANCE COMPANY | 199 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.