| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBRA VANSWEDEN3 Filed as: DEBRA WRIGHT | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $69K | $0 | $69K | 3.00% |
| MICHELLE R. STOUFFER3 Filed as: MICHELLE STOUFFER | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | $0 | $9K | 6.06% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $3K | $3K | 1.93% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $7K | $20K | 14.22% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MICHIGAN | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| LIFETIME FINANCIAL GROWTH OF MI3 | UNKNOWN KALAMAZOO, MI 49048 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $84 | $0 | $84 | 0.30% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $2K | $0 | $2K | 10.81% |
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 | 229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 561 | $2.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 579 | $148K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 393 | $22K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $142K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $142K |
| Prescription drug | PRIORITY HEALTH | 561 | $2.3M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 579 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.