| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA CLINE3 | PO BOX 50631 KALAMAZOO, MI 49005 | PRIORITY HEALTH | $23K | $0 | $23K | 1.55% |
| CARL G. HOFMANN3 | 1 IONIA AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $23K | $0 | $23K | 1.55% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 1 IONIA AVENUE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 2.39% |
| PATRICIA CLINE3 | 500 NORTH WATER STREET, SUITE 900 CORPUS CHRISTI, TX 78401 | DELTA DENTAL OF MICHIGAN | $847 | $0 | $847 | 0.77% |
| ACRISURE LLC3 | 444 WEST MICHIGAN AVENUE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 11.05% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 1 IONIA AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.10% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP, INC. | 1 IONIA AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $816 | $0 | $816 | 5.83% |
| ACRISURE LLC3 | 444 WEST MICHIGAN AVENUE KALAMAZOO, MI 49007 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $681 | $0 | $681 | 4.87% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 297 | $1.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 311 | $111K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 231 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $70K |
| Prescription drug | PRIORITY HEALTH | 297 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.