| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | 4171 S OCEANA DRIVE NEW ERA, MI 49446 | ARDELLIS INSURANCE LIMITED | $18K | — | $18K | 6.88% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| THE LEAD AGENCY LLC | 5797 HARVEY ST STE A MUSKEGON, MI 49444 | EYEMED VISION CARE | $2K | — | $2K | 10.07% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 20.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $925 | — | $925 | 10.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| THE LEAD AGENCY LLC3 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $273 | — | $273 | 9.99% |
| THE LEAD AGENCY LLC | 5797 HARVEY ST STE A MUSKEGON, MI 49444 | EYEMED VISION CARE | $16 | — | $16 | 7.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $11K |
| THE LEAD AGENCY, LLC DBA LAKESHORE AGENT/AGENCY | Insurance agents and brokers Service code 22 | 5797 HARVEY ST STE A NORTON SHORES, MI 49444 | $5K |
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 | 289 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | EYEMED VISION CARE | 289 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $33K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $32K |
| Stop-loss / reinsurancereinsurance | ARDELLIS INSURANCE LIMITED | 146 | $264K |
| Other(6 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.