| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N. ROSE ST. KALAMAZOO, MI 49007 | DELTA DENTAL | $7K | — | $7K | 3.00% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N. ROSE ST. KALAMAZOO, MI 49007 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.72% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N. ROSE ST. KALAMAZOO, MI 49007 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 13.41% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N. ROSE ST. KALAMAZOO, MI 49007 | EYEMED VISION CARE | $357 | — | $357 | 9.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRIORITY HEALTH INSURANCE COMPANY EIN 20-1529553 CARRIER/CLAIMS PROCESSOR | Claims processing Service code 12 | 1231 EAST BELTLINE AVE NE GRAND RAPIDS, MI 49425 | $594K |
| ROSE STREET ADVISORS EIN 27-2344362 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 244 N. ROSE ST KALAMAZOO, MI 49007 | $69K |
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 | 541 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 784 | $218K |
| Vision | EYEMED VISION CARE | 690 | $4K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $164K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $164K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $164K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 525 | $246K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 784 | — |
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.