| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHELLE R. STOUFFER3 Filed as: MICHELLE R STOUFFER | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $46K | $0 | $46K | 2.93% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $812 | $812 | 0.05% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 140 MONROE CENTER STREET NW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 4.74% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 18.43% |
| HNI RISK SERVICES | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 7.59% |
| PREMIER BENEFITS GROUP INC3 Filed as: PREMIER BENEFITS GROUP, LLC | 138 WEST GRAND RIVER AVENUE WILLIAMSTON, MI 48895 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $65 | $0 | $65 | 15.51% |
| KP INSURANCE AGENCY, LLC3 | 928 WEST COLUMBIA AVENUE, SUITE B BATTLE CREEK, MI 49015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 3.82% |
| CLARY JINKS3 | 403 MARSHALL STREET COLDWATER, MI 49036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 276 | $1.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 289 | $109K |
| Vision | VISION SERVICE PLAN | 110 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $75K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $75K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 276 | $1.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.