| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | P.O. BOX 6392 3033 ORCHARD VISTA S.E. GRAND RAPIDS, MI 49516 | VALENZ/SIRIUS AMERICA | $8K | $0 | $8K | 3.00% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST NW STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $6K | 14.77% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST NW STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 20.66% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST NW STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.68% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST NW, STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $853 | $2K | 15.82% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 50 LOUIS ST. NW STE 510 GRAND RAPIDS, MI 495032893 | VISION SERVICE PLAN | $878 | $0 | $878 | 6.45% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST NW STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $703 | $2K | 21.33% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS ST STE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $889 | $372 | $1K | 21.28% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | VALENZ/SIRIUS AMERICA | 118 | $265K |
| Vision | VISION SERVICE PLAN | 69 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $27K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $19K |
| Stop-loss / reinsurancereinsurance | VALENZ/SIRIUS AMERICA | 118 | $265K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.