| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK D YOUNG3 Filed as: MARK D. YOUNG | FOUR EMBARCADERO CENTER SAN FRANCISCO, CA 94111 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $36K | $0 | $36K | 1.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4 EMBARCADERO CENTER, SUITE 400 SAN FRANCISCO, CA 94111 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $3K | $3K | 0.12% |
| PATRICK D DALTON3 Filed as: PATRICK D. DALTON | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | $0 | $2K | 0.09% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $25K | $1K | $26K | 11.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 3.64% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER INC | 800 WEST MAIN STREET, SUITE 1250 BOISE, ID 83702 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 2.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 0.79% |
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 | 288 | 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) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 460 | $2.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 393 | $144K |
| Vision | VISION SERVICE PLAN | 158 | $27K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $221K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $221K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $221K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 460 | $2.3M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 460 | — |
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.