| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | 3033 ORCHARD VISTA SE GRAND RAPIDS, MI 49546 | SYMETRA | $13K | — | $13K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS, HENDRICKS, STUIT INS AG | P.O. BOX 953 GRANDVILLE, MI 49468 | METROPOLITAN LIFE INSURANCE | — | — | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS, HENDRICKS, STUIT INS AG | P.O. BOX 953 GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 11.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 THIRD PARTY ADMIN | Contract Administrator Service code 13 | 3033 ORCHARD VISTA SE GRAND RAPIDS, MI 49546 | $80K |
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 | 520 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE | 353 | $131K |
| Vision | METROPOLITAN LIFE INSURANCE | 353 | $131K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $65K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $65K |
| Stop-loss / reinsurancereinsurance | SYMETRA | 152 | $327K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.