| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CSI INSURANCE PLAN AND TRUST FUND4 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | PRIORITY HEALTH | $290K | — | $290K | 3.84% |
| CSI INSURANCE PLAN AND TRUST FUND3 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | DELTA DENTAL OF MICHIGAN | $30K | — | $30K | 3.00% |
| CSI INSURANCE PLAN AND TRUST FUND3 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | HARTFORD LIFE AND ACCIDENT | $11K | $3K | $14K | 2.17% |
| CSI INSURANCE PLAN AND TRUST FUND3 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | VISION SERVICE PLAN | $3K | — | $3K | 2.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COORDINATED ADMINISTRATIVE SERVICES EIN 38-2716869 NONE KNOWN | Other fees; Other services; Contract Administrator; Copying and duplicating; Direct payment from the plan Service code 13 | — | $248K |
| MORNEAU SHEPELL LIMITED EIN 52-1883918 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $74K |
| MERCER HEALTH & BENEFITS, LLC EIN 13-2834414 NONE KNOWN | Direct payment from the plan; Consulting (general) Service code 16 | — | $53K |
| WARNER, NORCROSS & JUDD LLP EIN 38-1422647 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $23K |
| PLANTE & MORAN PLLC EIN 38-1357951 NONE KNOWN | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| NATIONAL INSURANCE PRODUCER REGISTR NONE KNOWN | Direct payment from the plan; Insurance services Service code 23 | 1100 WALNUT STREET SUITE 1500 KANSAS CITY, MO 64106 | $12K |
| MARSH & MCLENNAN AGENCY LLC EIN 26-3237576 NONE KNOWN | Insurance services; Insurance brokerage commissions and fees; Direct payment from the plan Service code 23 | — | $10K |
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 | 1,859 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 302 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 2,143 | $7.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 2,573 | $1.0M |
| Vision | VISION SERVICE PLAN | 565 | $120K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,812 | $630K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,812 | $630K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,812 | $630K |
| Prescription drug | PRIORITY HEALTH | 2,143 | $7.5M |
| Other | HARTFORD LIFE AND ACCIDENT | 2,812 | $630K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,812 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.