| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL J. FREIHOFER3 | 200 OTTAWA AVENUE NW, SUITE 403 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $43K | — | $43K | 3.10% |
| FOX INSURANCE AGENCY LLC3 | 200 OTTAWA AVENUE NW, SUITE 403 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.24% |
| FOX INSURANCE AGENCY LLC3 | 200 OTTAWA AVENUE NW, SUITE 801 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $55K | — | $55K | 12.42% |
| BENEFIT PROFILES INC3 | 4500 CASCADE RD SE STE 106 GRAND RAPIDS, MD 49546 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 0.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | P.O. BOX 28852 NEW YORK, NY 10087 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.01% |
| PAUL J. FREIHOFER3 Filed as: PAUL FREIHOFER | 300 OTTAWA AVE NW SUITE 220 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $17 | — | $17 | 0.00% |
| FOX INSURANCE AGENCY LLC3 Filed as: DP FOX HOLDINGS, LLC | 200 OTTAWA AVE NW, SUITE 801 GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 2.92% |
| FOX INSURANCE AGENCY LLC3 | 200 OTTAWA AVENUE NW, SUITE 801 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 16.22% |
| BENEFIT PROFILES INC3 | 4500 CASCADE RD SE STE 106 GRAND RAPIDS, MI 49546 | METROPOLITAN LIFE INSURANCE COMPANY | $467 | — | $467 | 1.03% |
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 | 991 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,008 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 1,622 | $5.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,622 | $1.4M |
| Vision | VISION SERVICE PLAN | 671 | $77K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,694 | $439K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,694 | $439K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,694 | $439K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 1,622 | $5.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,694 | $439K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,694 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.