| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | PO BOX 6392 GRAND RAPIDS, MI 49516 | ARDELLIS INSURANCE LIMITED | $21K | $0 | $21K | 3.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $923K |
| INDEPENDENCE ADMINISTRATORS EIN 23-2184623 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $52K |
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 | 1,615 | 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) | 1,615 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENCE ADMINISTRATORS | 245 | $147K |
| Prescription drug | INDEPENDENCE ADMINISTRATORS | 245 | $147K |
| Stop-loss / reinsurancereinsurance | ARDELLIS INSURANCE LIMITED | 1,615 | $606K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,615 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.