| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT SETTLE3 Filed as: SCOTT E. BLOEM | P.O. BOX 295 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $26K | $36K | 13.39% |
| MARC D. DEVISSER3 | 140 MONROE CTR GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 2.63% |
| CARRIE A. FARNUM3 | P.O. BOX 295 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.87% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.42% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC EMPLOYEE BNFT SVCS OF WES | P.O. BOX 295 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.41% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC EMPLOYEE BNFT SVCS | 55 CAMPAU SUITE 400 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 8.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing; Other fees Service code 12 | — | $140K |
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 | 211 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 178 | $272K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $104K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $104K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $104K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 178 | $272K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 178 | $272K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.