| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWRENCE DUANE BOS3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $222 | $454 | $676 | 2.58% |
| JAMES R ALTON3 Filed as: JAMES D KIMBALL | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $104 | $42 | $146 | 0.56% |
| WESTERN MI GROUP LLC3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $113 | $10 | $123 | 0.47% |
| GENE J GILMORE3 | 55 CAMPAU AVE NW STE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $13 | $5 | $18 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ONEAMERICA RETIREMENT SERVICES LLC EIN 46-5378846 NONE | Recordkeeping fees; Account maintenance fees; Direct payment from the plan; Distribution (12b-1) fees; Shareholder servicing fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant loan processing; Participant communication Service code 15 | — | $40K |
| WELLS FARGO ADVISORS, LLC EIN 34-1542819 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $33K |
| BMO HARRIS BANK, N.A. EIN 36-2085229 NONE | Investment management; Custodial (securities); Trustee (directed); Float revenue; Soft dollars commissions; Investment management fees paid indirectly by plan; Trustee (bank, trust company, or similar financial institution) Service code 19 | — | $0 |
| FIRST CLEARING LLC NONE | Securities brokerage commissions and fees Service code 71 | ONE NORTH JEFFERSON, H0005-072 ST. LOUIS, MO 63103 | $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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | NORTHWESTERN MUTUAL | 22 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22 | — |
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.