| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY MCCULLOCH3 | 56 GRANDVILLE AVENUE SW GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $12K | $0 | $12K | 3.00% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW, SUITE 101 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $533 | $0 | $533 | 0.90% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $121 | $121 | 0.20% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVENUE SW SUITE 300 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.66% |
| DONALD LIKENS3 Filed as: DONALD LEE LIKENS | 8833 PERIMETER PARK BOULEVARD SUITE 802 JACKSONVILLE, FL 32216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $90 | $0 | $90 | 0.23% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $61 | $90 | 0.23% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $68 | $0 | $68 | 0.17% |
| ROBERT J. MAYER3 | 398 ACORN CIRCLE COTOPAXI, CO 81223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.10% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 56 GRANDVILLE AVENUE SW SUITE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 13.26% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $226 | $0 | $226 | 0.77% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES | 75 REMITTANCE DRIVE, SUITE 1446 CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $97 | $0 | $97 | 0.33% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVENUE NW, SUITE 100 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | $0 | $10 | 0.03% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | PO BOX 1439 HOLLAND, MI 49422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $263 | $4K | 15.89% |
| AMY MCCULLOCH3 | 56 GRANDVILLE AVENUE SW GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $269 | $0 | $269 | 3.00% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PRIORITY HEALTH | 112 | $618K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 150 | $59K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 150 | $59K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $68K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $68K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $28K |
| Prescription drug(3 contracts, 3 carriers) | PRIORITY HEALTH | 112 | $618K |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 135 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.