| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SWARDENSKI, KURT B3 | 89 MONROE CTR NW, STE 200 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $21K | — | $21K | 1.35% |
| WIERENGA, BETH3 | 200 OTTAWA NW, STE 801 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $10K | — | $10K | 0.65% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 1 IONIA AVE SW STE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $333 | $3K | 5.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | STE 408, 30150 TELEGRAPH RD BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $102 | $102 | 0.19% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 1 IONIA AVE SW STE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 12.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | STE 408, 30150 TELEGRAPH RD BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $614 | — | $614 | 2.63% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER NW SUITE 200 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE | $807 | — | $807 | 6.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH RD BINGHAM FARMS, MI 480255708 | EYEMED VISION CARE | $271 | — | $271 | 2.28% |
| ADVANTAGE BENEFITS GROUP3 | 89 MONROE CENTER NW GRAND RAPIDS, MI 49503 | EYEMED VISION CARE | $97 | — | $97 | 0.82% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 1 IONIA AVE SW STE 300 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 12.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | STE 408, 30150 TELEGRAPH RD BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $235 | — | $235 | 2.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $20 | $20 | 0.19% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 330 | $1.5M |
| Vision | EYEMED VISION CARE | 205 | $12K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $63K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $53K |
| Prescription drug | PRIORITY HEALTH | 330 | $1.5M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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.