| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARMAN M. BAINES3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH INSURANCE COMPANY | $31K | $0 | $31K | 3.00% |
| CARMAN M. BAINES3 | 333 BRIDGE STREET NW, SUITE 400 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH | $20K | $0 | $20K | 3.00% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF MICHIGAN | $6K | $562 | $7K | 5.15% |
| NORTHWEST WORKSITE MARKETING CORP3 Filed as: NORTHWEST WORKSITE MARKETING CORP. | 1910 INDIANWOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $104 | $2K | 9.22% |
| 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 | 6.22% |
| DAN YAARY3 | 1910 INDIAN WOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $84 | $1K | 5.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $930 | $0 | $930 | 4.20% |
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 | 273 | 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) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH INSURANCE COMPANY | 211 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 365 | $126K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 359 | $22K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 35 | $25K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 35 | $25K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH INSURANCE COMPANY | 211 | $1.7M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 35 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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.