| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLE M. SHUPLE3 | 300 OTTAWA NW, SUITE 301 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $35K | — | $35K | 3.04% |
| COLE M. SHUPLE3 | 300 OTTAWA NW, SUITE 301 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $16K | $0 | $16K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $7K | $0 | $7K | 5.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 2.63% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $25 | $25 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 9.23% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER & ASSOCIATES, LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $892 | $0 | $892 | 11.90% |
| KELLY M TIMMONS4 Filed as: KELLY M. TIMMONS | 617 TIMOTHY LANE, APARTMENT 101 ROCHESTER, MI 48307 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $131 | — | $131 | 1.75% |
| PETRILL AND ASSOCIATES LLC4 Filed as: PETRILL AND ASSOCIATES, LLC | 439 CHRISTOPHER ROAD SHELBY, NC 28152 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $54 | — | $54 | 0.72% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 151 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 229 | $118K |
| Vision | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 216 | $28K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $100K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $100K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $100K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 151 | $1.7M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.