| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $47K | $6K | $52K | 32.54% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 6.48% |
| JOY A RYBICKI3 Filed as: JOY A. RYBICKI | 71-129TH AVENUE WAYLAND, MI 49348 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 2.44% |
| MARY M CAMPBELL3 Filed as: MARY M. CAMPBELL | 9480 WEST Y AVENUE SCHOOLCRAFT, MI 49087 | CONTINENTAL AMERICAN INSURANCE COMPANY | $692 | $0 | $692 | 0.95% |
| MJ INSURANCE3 Filed as: WILLIAM JOHNSON AND VARIOUS AGENTS | 1755 INDIAN LAKES CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $596 | $0 | $596 | 0.82% |
| K HARRIS & ASSOCIATES, LLC3 Filed as: K HARRIS & ASSOCIATES LLC | 950 WEST NORTON AVENUE, SUITE 201 MUSKEGON, MI 49441 | CONTINENTAL AMERICAN INSURANCE COMPANY | $588 | $0 | $588 | 0.81% |
| SANTIAGO & ASSOCIATES LLC3 | 950 WEST NORTON AVENUE, SUITE 201 MUSKEGON, MI 49441 | CONTINENTAL AMERICAN INSURANCE COMPANY | $435 | $0 | $435 | 0.60% |
| RAY W HINKLE3 Filed as: RAY W. HINKLE | 6062 ARCHER STREET NE ROCKFORD, MI 49341 | CONTINENTAL AMERICAN INSURANCE COMPANY | $391 | $0 | $391 | 0.54% |
| MICHIGAN CHAMBER SERVICES, INC.3 Filed as: MICHIGAN CHAMBER SERVICES INC | 600 SOUTH WALNUT STREET LANSING, MI 48933 | VISION SERVICE PLAN | $2K | $0 | $2K | 13.64% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET SUITE 200 GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $933 | $0 | $933 | 6.56% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN | $482 | $0 | $482 | 3.39% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $160K |
| Vision | VISION SERVICE PLAN | 117 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $160K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $160K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.