| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWRENCE DUANE BOS3 | 85 CAMPAU AVE NW GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $275 | $470 | $745 | 2.65% |
| WESTERN MI GROUP LLC3 | 85 CAMPAU AVE NW GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $275 | $24 | $299 | 1.06% |
| JAMES R ALTON3 Filed as: JAMES D KIMBALL | 85 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $121 | $49 | $170 | 0.61% |
| GENE J GILMORE3 | 85 CAMPAU AVE NW GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $17 | $7 | $24 | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ONEAMERICA RETIREMENT SERVICES LLC EIN 46-5378846 NONE | Distribution (12b-1) fees; Participant loan processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Recordkeeping fees; Shareholder servicing fees; Participant communication; Account maintenance fees Service code 15 | — | $44K |
| WELLS FARGO ADVISORS, LLC NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | 146 MONROE CENTER NW, SUITE 530 GRAND RAPIDS, MI 49503 | $41K |
| BMO HARRIS BANK, N.A. EIN 36-2085229 NONE | Trustee (directed); Trustee (bank, trust company, or similar financial institution); Custodial (securities) Service code 19 | — | $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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | NORTHWESTERN MUTUAL | 23 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 23 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.