| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | 9.60% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $337 | $2K | 1.34% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $2K | $15K | 22.62% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | VISION SERVICES PLAN (VSP) | $6K | — | $6K | 10.01% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $831 | $5K | 11.84% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $311 | $2K | 12.28% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 15.41% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DR SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $816 | $392 | $1K | 10.90% |
| JEREMY SAMPSEL3 | 401 HALL ST SW, STE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $399 | $386 | $785 | 7.08% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT N JACKSON, MI 49201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $439 | — | $439 | 3.96% |
| DIANNA LYNN ATCHISON3 | 225 E DIVISION ST ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | $41 | $280 | 2.53% |
| TIMOTHY JOEL WYNSMA3 | 7561 14TH AVE JENISON, MI 49428 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 1.23% |
| SUSAN MARIE WEITKAMP3 | 246 FIDDLECREEK RIDGE RD WENTZVILLE, MO 63385 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $5 | $14 | 0.13% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $363 | — | $363 | 9.99% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $298 | — | $298 | 10.00% |
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $272 | $68 | $340 | 12.52% |
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 | 317 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH INSURANCE COMPANY | 420 | $375K |
| Dental | DELTA DENTAL OF MICHIGAN | 455 | $176K |
| Vision | VISION SERVICES PLAN (VSP) | 254 | $55K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $14K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $41K |
| Prescription drug | PRIORITY HEALTH INSURANCE COMPANY | 420 | $375K |
| Other(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 317 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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.