| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC D. DEVISSER3 | 50 LOUIS STREET NW, SUITE 200 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $13K | $0 | $13K | 1.45% |
| MICHELLE R. STOUFFER3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $10K | $0 | $10K | 1.18% |
| MICHELLE R. STOUFFER3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 1.82% |
| MARC D. DEVISSER3 | 50 LOUIS STREET NW, SUITE 200 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $0 | $4K | 1.14% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | $3K | $15K | 18.25% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 34.35% |
| SANTIAGO & ASSOCIATES LLC3 Filed as: SANTIAGO AND ASSOCIATES LLC | 950 WEST NORTON AVENUE, SUITE 201 MUSKEGON, MI 49441 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 32.50% |
| K HARRIS & ASSOCIATES, LLC3 Filed as: K. HARRIS AND ASSOCIATES, LLC | 950 WEST NORTON AVENUE, SUITE 201 MUSKEGON, MI 49441 | CONTINENTAL AMERICAN INSURANCE COMPANY | $857 | $0 | $857 | 6.25% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | EYEMED | $1K | $0 | $1K | 10.62% |
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 | 193 | 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) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 324 | $1.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 324 | $327K |
| Vision | EYEMED | 189 | $12K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $84K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $84K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $84K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 324 | $1.2M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.