| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARMAN M. BAINES3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH | $35K | $0 | $35K | 2.52% |
| CARRIE FARNUM3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH | $7K | $0 | $7K | 0.53% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF MICHIGAN | $6K | $139 | $6K | 5.10% |
| BENEFIT PROFILES INC3 Filed as: BENEFIT PROFILES, INC. | 500 CASCADE WEST PARKWAY GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $148 | $0 | $148 | 0.13% |
| CARMAN M. BAINES3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 2.96% |
| CARRIE FARNUM3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH INSURANCE COMPANY | $408 | $0 | $408 | 0.54% |
| NORTHWEST WORKSITE MARKETING CORP3 Filed as: NORTHWEST WORKSITE MARKETING CORP. | 1910 INDIANWOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $192 | $3K | 11.73% |
| SWANSON-PHILLIPS & ASSOC3 Filed as: SWANSON PHILLIPS & ASSOCIATES, LLC | 833 KENMOOR AVENUE SE GRAND RAPIDS, MI 49546 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 8.77% |
| DAN YAARY3 | 1910 INDIAN WOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $112 | $2K | 6.66% |
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 | 221 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 269 | $1.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 348 | $112K |
| Vision(3 contracts, 3 carriers) | PRIORITY HEALTH | 269 | $1.5M |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 39 | $24K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 39 | $24K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 269 | $1.5M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 39 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.