| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUG CALKINS3 | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $0 | $15K | 1.82% |
| BRUCE J. WALDECKER3 | 2780 44TH STREET SW WYOMING, MI 49519 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | $0 | $9K | 1.15% |
| LIGHTHOUSE GROUP3 | 56 GRANDVILLE AVENUE, SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $5K | $5K | 0.62% |
| LIGHTHOUSE GROUP3 | 56 CESAR EAST CHAVEZ AVENUE SW SUITE 300 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $79 | $2K | 3.92% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $627 | $0 | $627 | 1.23% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DRIVE, SUITE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $90 | $90 | 0.18% |
| LIGHTHOUSE GROUP3 | 56 GRANDVILLE AVENUE SW, SUITE 300 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $481 | $5K | 10.00% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURERS GROUP, INC. | 1995 POINT TOWNSHIP DRIVE NORTHUMBERLAND, PA 17857 | METROPOLITAN LIFE INSURANCE COMPANY | $186 | $4K | $4K | 8.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $484 | $3K | 5.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.77% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.11% |
| LIGHTHOUSE GROUP3 | 56 GRANDVILLE AVENUE, SUITE 300 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 15.01% |
| OLIVIER VANDYK INSURANCE3 | 2780 44TH STREET SW WYOMING, MI 49519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.18% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 129 | $800K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 87 | $51K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 186 | $46K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 186 | $46K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 186 | $46K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 129 | $800K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 186 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.