| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NICKEL, JASON3 | 56 GRANDVILLE AVE ST 300 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $97K | — | $97K | 3.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP, INC. | 56 GRANDVILLE AVE SW, STE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $9K | $1K | $10K | 3.26% |
| NICKEL, JASON3 | 56 GRANDVILLE AVE ST 300 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 24.81% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOORE AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.04% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $451 | $2K | 12.42% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $695 | $2K | 20.82% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $626 | $2K | 23.23% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $739 | $220 | $959 | 12.98% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY INC | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 3.49% |
| BRAD SCOFFIN3 | 7931 TS AVENUE EAST SCOTTS, MI 49088 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 2.56% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | — |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INS GROUP INC | 4808 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $31 | $31 | — |
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 | 333 | 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) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 786 | $3.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 798 | $312K |
| Vision | VISION SERVICE PLAN | 321 | $38K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $7K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 786 | $3.4M |
| Other(8 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 218 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 798 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.