| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY L. MCCULLOCH3 | 4808 BROADMOORE SE GRAND RAPIDS, MI 49512 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $1K | $5K | 8.13% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $364 | $0 | $364 | 0.63% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $524 | $3K | 5.78% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE GROUP INSURANCE | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 2.57% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $291 | $0 | $291 | 0.62% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $125 | $0 | $125 | 0.27% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE GROUP INSURANCE | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.73% |
| DONALD LIKENS3 Filed as: DONALD LEE LIKENS | 8833 PERIMETER PARK BOULEVARD SUITE 802 JACKSONVILLE, FL 32216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $0 | $149 | 0.33% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 0.20% |
| ROBERT J. MAYER3 | 398 ACORN CIRCLE COTOPAXI, CO 81223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.16% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.08% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.38% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 144 | $281K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 132 | $75K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 125 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 159 | $47K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 144 | $281K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 159 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.