| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID A KUIPER3 | 6205 EASTRIDGE DR HUDSONVILLE, MI 49426 | PRINCIPAL LIFE INSURANC COMPANY | $0 | $25 | $25 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRINCIPAL SECURITIES INC EIN 42-0941553 OTHER SERVICES | Other commissions; Other services Service code 49 | — | $5K |
| PRINCIPAL LIFE INSURANCE COMPANY EIN 42-0127290 CONTRACT ADMINISTRATOR | Recordkeeping fees; Direct payment from the plan; Participant loan processing; Contract Administrator Service code 13 | — | $5K |
| WILSHIRE ASSOCIATES INCORPORATED EIN 95-2755361 INVESTMENT ADVISORY | Investment advisory (plan); Other investment fees and expenses Service code 27 | — | $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 | 245 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 53 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 2 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRINCIPAL LIFE INSURANC COMPANY | 2 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.