| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREGG FARR3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $0 | $40 | $40 | — |
| GREG FARR3 | 5500 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $0 | $45 | $45 | — |
| TIMOTHY DILLON3 Filed as: TIMOTHY M DILLON | 12 WASHINGTON AVE STE 200 GRAND RAPIDS, MI 49417 | NORTHWESTERN MUTUAL | $0 | $39 | $39 | — |
| CHUCK SAMFILIPPO3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $10 | $4 | $14 | — |
| JD GENERAL AGENCY LLC3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $3 | $0 | $3 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PLANT MORAN EIN 38-1357951 AUDITING | Accounting (including auditing) Service code 10 | — | $17K |
| FIDELITY INVESTMENTS INSTITUTIONAL EIN 04-2647786 RECORDKEEPER | Recordkeeping fees; Participant loan processing; Securities brokerage commissions and fees; Account maintenance fees Service code 37 | — | $10K |
| AMERICAN CENTURY EIN 44-6006315 INVESTMENT PROVIDER | Sub-transfer agency fees; Investment management fees paid indirectly by plan; Other insurance wrap fees Service code 52 | — | $0 |
| MASS MUTUAL LIFE INS COMPANY EIN 04-1590850 CONTRACT ADMINSTRATOR | Sub-transfer agency fees; Other insurance wrap fees; Soft dollars commissions; Investment management fees paid indirectly by plan; Other investment fees and expenses; Float revenue Service code 52 | — | $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 | 243 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 76 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | NORTHWESTERN MUTUAL | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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.