| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELODIE CLAUSEN3 | 2780 44TH STREET SW WYOMING, MI 49519 | PRIORITY HEALTH | $69K | $0 | $69K | 3.00% |
| MELODIE CLAUSEN3 | 2780 44TH STREET SW WYOMING, MI 49519 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 3.07% |
| OLIVIER VANDYK INSURANCE3 Filed as: OLIVIER VANDYK INSURANCE AGENCY | 2780 44TH STREET SW WYOMING, MI 49519 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | $0 | $29K | 14.97% |
| OLIVIER VANDYK INSURANCE3 Filed as: OLIVIER VANDYK INSURANCE AGENCY | 2780 44TH STREET SW WYOMING, MI 49519 | EYEMED | $3K | $0 | $3K | 9.88% |
| ROBERT J. MCCORMICK III LLC4 Filed as: ROBERT J. MCCORMICK III, LLC | 408 CHICAGO DRIVE, UNIT 341 JENISON, MI 49429 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $3K | $0 | $3K | 22.93% |
| STEVEN L. JONES4 | 3182 RIVERVIEW DRIVE NW APARTMENT 3A GRAND RAPIDS, MI 49544 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $141 | $0 | $141 | 1.04% |
| STEVEN STABLEIN4 | 2131 DUNNIGAN AVENUE NE GRAND RAPIDS, MI 49525 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $16 | $0 | $16 | 0.12% |
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 | 280 | 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) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 561 | $2.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 574 | $201K |
| Vision | EYEMED | 428 | $30K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 276 | $196K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 276 | $196K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 276 | $196K |
| Prescription drug | PRIORITY HEALTH | 561 | $2.3M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 276 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 574 | — |
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."
No prospect flags tripped on this filing.