| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER T FISHER LLC3 Filed as: CHRISTOPHER WERME | 244 N. ROSE STREET KALAMAZOO, MI 49007 | PRIORITY HEALTH | $31K | — | $31K | 3.00% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N. ROSE STREET KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $3K | $17K | 14.54% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N. ROSE STREET KALAMAZOO, MI 49007 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 5.61% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N. ROSE STREET KALAMAZOO, MI 49007 | EYEMED | $1K | — | $1K | 10.00% |
| ROSE STREET ADVISORS LLC3 | 244 NORTH ROSE STREET KALAMAZOO, MI 49007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $577 | — | $577 | 9.46% |
| KIMBERLY JILL ZBIKOWSKI3 | 1786 DEEPWOOD DRIVE SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $336 | $128 | $464 | 7.60% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $268 | $93 | $361 | 5.92% |
| JEREMY SAMPSEL3 | 401 HALL STREET SW GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $104 | $218 | 3.57% |
| SHAMROCK BENEFITS LLC3 | 3941 CRYSTAL WATERS LANE NE GRAND RAPIDS, MI 49525 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 3.28% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $2 | $65 | 1.07% |
| MARY LOU TAYLOR3 | 11176 WILLMINGTON BLVD ENGLEWOOD, FL 34224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.07% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 195 | $1.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 200 | $54K |
| Vision | EYEMED | 169 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $118K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $118K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $118K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.