| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | 618 KENMOOR AVE SE, SUITE 200 GRAND RAPIDS, MI 49546 | SYMETRA | $25K | — | $25K | 4.00% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CTR NW STE 200 GRAND RAPIDS, MI 49508 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $425 | $1K | 2.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AG | PO BOX 953 GRANDVILLE, MI 49468 | STARMOUNT LIFE INSURANCE COMPANY | $228 | $71 | $299 | 0.44% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CTR NW STE 200 GRAND RAPIDS, MI 49508 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $956 | $193 | $1K | 3.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AG | PO BOX 953 GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $200 | $23 | $223 | 0.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 THIRD-PARTY ADMIN. | Contract Administrator Service code 13 | — | $45K |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 365 | $67K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 454 | $16K |
| Life insurance(2 contracts, 2 carriers) | STARMOUNT LIFE INSURANCE COMPANY | 365 | $98K |
| Long-term disability | STARMOUNT LIFE INSURANCE COMPANY | 365 | $67K |
| Stop-loss / reinsurancereinsurance | SYMETRA | 156 | $617K |
| Other | STARMOUNT LIFE INSURANCE COMPANY | 365 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.