| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BLOEM3 | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 495010295 | PRIORITY HEALTH | $27K | — | $27K | 7.07% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 495010295 | CIGNA GROUP INSURANCE | $5K | $0 | $5K | 9.96% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 495010295 | VISION SERVICE PLAN | $1K | — | $1K | 4.78% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 49501 | CIGNA GROUP INSURANCE | $3K | $0 | $3K | 13.96% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 495010295 | CIGNA GROUP INSURANCE | $624 | $0 | $624 | 5.00% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 55 CAMPAU AVE NW STE 400 PO BOX 295 GRAND RAPIDS, MI 49501 | CIGNA GROUP INSURANCE | $138 | $0 | $138 | 4.98% |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 617 | $383K |
| Dental | PRIORITY HEALTH | 617 | $383K |
| Vision | VISION SERVICE PLAN | 179 | $28K |
| Life insurance | CIGNA GROUP INSURANCE | 314 | $12K |
| Long-term disability | CIGNA GROUP INSURANCE | 290 | $19K |
| Other(2 contracts) | CIGNA GROUP INSURANCE | 314 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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.