| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLY J. MARTYNIEK3 Filed as: WALLY J MARTYNIEK | 721 3 MILE RD NW 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $34K | — | $34K | 2.59% |
| WALLY J. MARTYNIEK3 Filed as: WALLY J MARTYNIEK | 721 THREE MILE DR STE 150 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD | — | — | $0 | 0.00% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHIELD | — | — | $0 | 0.00% |
| SPECTRUM BENEFITS LLC3 | 721 3 MILE RD NW 150 GRAND RAPIDS, MI 49544 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.83% |
| SPECTRUM BENEFITS LLC3 | 721 3 MILE RD NW 150 GRAND RAPIDS, MI 49544 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 13.81% |
| SPECTRUM BENEFITS LLC3 | 721 3 MILE RD NW 150 GRAND RAPIDS, MI 49544 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $563 | — | $563 | 9.19% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD 150 GRAND RAPIDS, MI 49546 | THE HARTFORD INSURANCE COMPANY | $188 | — | $188 | 15.04% |
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 | 501 | 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) | 501 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 501 | $1.5M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $39K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $7K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $44K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 501 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.