| 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 | $244K | — | $244K | 2.46% |
| CSI INSURANCE PLAN AND TRUST FUND3 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | DELTA DENTAL OF MICHIGAN | $32K | — | $32K | 3.01% |
| CSI INSURANCE PLAN AND TRUST FUND4 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | HARTFORD LIFE AND ACCIDENT | $21K | — | $21K | 2.79% |
| CSI INSURANCE PLAN AND TRUST FUND4 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | VISION SERVICE PLAN | $3K | — | $3K | 2.44% |
| CSI INSURANCE PLAN AND TRUST FUND3 | 2969 PRAIRIE ST SW, STE 102 GRANDVILLE, MI 494182008 | PRIORITY HEALTH INSURANCE COMPANY | $2K | — | $2K | 4.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CEB SERVICES EIN 99-3927114 NONE KNOWN | Other fees; Copying and duplicating; Direct payment from the plan; Contract Administrator; Other services Service code 13 | — | $394K |
| COORDINATED ADMINISTRATIVE SERVICES EIN 38-2716869 NONE KNOWN | Contract Administrator; Copying and duplicating; Other services; Direct payment from the plan; Other fees Service code 13 | — | $136K |
| MERCER HEALTH & BENEFITS, LLC EIN 34-2015463 NONE KNOWN | Consulting fees; Direct payment from the plan; Consulting (general) Service code 16 | — | $46K |
| GRAF-MARTIN COMMUNICATIONS INC. EIN 81-8283699 NONE KNOWN | Consulting (general); Other services; Direct payment from the plan Service code 16 | — | $43K |
| WARNER, NORCROSS & JUDD LLP EIN 38-1422647 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $41K |
| MERRILL LYNCH, PIERCE, FENNER & SMI EIN 13-5674085 NONE KNOWN | Investment management fees paid directly by plan; Custodial (securities); Direct payment from the plan; Investment advisory (plan) Service code 19 | — | $33K |
| PLANTE & MORAN, PLLC EIN 33-1498605 NONE KNOWN | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| NATIONAL INSURANCE PRODUCER REGISTR NONE KNOWN | Insurance services; Direct payment from the plan Service code 23 | 1100 WALNUT STREET SUITE 1500 KANSAS CITY, MO 64106 | $10K |
| LEGALEASE EIN 13-4256913 NONE KNOWN | Legal; Direct payment from the plan Service code 29 | — | $9K |
| KENT COMMUNICATIONS INC EIN 38-2071291 NONE KNOWN | Other fees; Other services; Direct payment from the plan Service code 49 | — | $8K |
| TELUS HEALTH (US) LTD. EIN 52-1883918 NONE KNOWN | Other services; Direct payment from the plan Service code 49 | — | $8K |
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 | 2,210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 189 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 2,306 | $10.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 2,523 | $1.1M |
| Vision | VISION SERVICE PLAN | 659 | $115K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,197 | $756K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 3,197 | $756K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,197 | $756K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 2,306 | $10.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 3,197 | $756K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,197 | — |
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.