| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBRA VANSWEDEN3 Filed as: DEBRA WRIGHT | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $28K | — | $28K | 3.20% |
| EMILY BLACKBURN3 | 525 EAST BROADWAY MOUNT PLEASANT, MI 48858 | PRIORITY HEALTH | $3K | — | $3K | 0.29% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | DEARBORN LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.66% |
| GENERAL AGENCY COMPANY3 Filed as: GENERAL AGENCY KAP, LLC | 525 EAST BORADWAY MOUNT PLEASANT, MI 48858 | DEARBORN LIFE INSURANCE COMPANY | $665 | $0 | $665 | 1.13% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | DELTA DENTAL MICHIGAN | $3K | — | $3K | 5.80% |
| BENEFIT PROFILES INC3 Filed as: BENEFIT PROFILES, INC. | 500 CASCADE WEST PARKWAY, SUITE 160 GRAND RAPIDS, MI 49546 | DELTA DENTAL MICHIGAN | $2K | — | $2K | 3.23% |
| GENERAL AGENCY COMPANY3 Filed as: GENERAL AGENCY KAP, LLC | 525 EAST BROADWAY STREET MOUNT PLEASANT, MI 48858 | DELTA DENTAL MICHIGAN | $271 | — | $271 | 0.48% |
| GENERAL AGENCY COMPANY3 Filed as: THE GENERAL AGENCY KAP. LLC | 525 EAST BROADWAY STREET MOUNT PLEASANT, MI 48858 | AMERITAS LIFE INSURANCE CORP. | $1K | $0 | $1K | 12.79% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS | 501 LOUIS STREET, SUITE 510 GRAND RAPIDS, MI 49503 | AMERITAS LIFE INSURANCE CORP. | $888 | $0 | $888 | 9.96% |
| DEBRA VANSWEDEN3 Filed as: DEBRA WRIGHT | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH INSURANCE COMPANY | $118 | — | $118 | 3.51% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 160 | $891K |
| Dental | DELTA DENTAL MICHIGAN | 172 | $56K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 156 | $9K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 94 | $59K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 94 | $59K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 94 | $59K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 160 | $891K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 94 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.