| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 1115 TAYLOR AVENUE N SUITE 112 GRAND RAPIDS, MI 49503 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 1115 TAYLOR AVENUE N SUITE 112 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.12% |
| LIGHTHOUSE GROUP3 Filed as: LIGHTHOUSE INSURANCE GROUP | 1115 TAYLOR AVENUE N SUITE 112 GRAND RAPIDS, MI 49503 | ANTHEM INSURANCE COMPANIES | $124K | — | $124K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINTON AVENUE HARTFORD, CT 06156 | $1.5M |
| ANTHEM INSURANCE COMPANIES EIN 35-0781558 CONTRACT ADMINISTRATOR | Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $255K |
| EXPRESS SCRIPTS EIN 31-1714795 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
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 | 2,990 | 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) | 2,990 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 365 | $151K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 301 | $303K |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 2,051 | $826K |
| Life insurance(3 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 3,137 | $779K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 365 | $35K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 365 | $49K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 2,550 | $1.5M |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 36 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,137 | — |
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."
No prospect flags tripped on this filing.