| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT PROFILES INC3 | 4500 CASCADE RD SE SUITE 106 GRAND RAPIDS, MI 495463665 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 1.34% |
| FOX INSURANCE AGENCY LLC3 Filed as: FOX INS AGENCY LLC | 200 OTTAWA AVE NW SUITE 801 GRAND RAPIDS, MI 495032426 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $773 | $3K | 0.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 30150 TELEGRAPH RD SUITE 408 BINGHAM FARMS, MI 48025 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | — | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 30150 TELEGRAPH RD SUITE 408 BINGHAM FARMS, MI 48025 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.00% |
| FOX INSURANCE AGENCY LLC3 | 200 OTTAWA AVE NW SUITE 403 GRAND RAPIDS, MI 49503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 30150 TELEGRAPH RD SUITE 408 BINGHAM FARMS, MI 48025 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 3.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 30150 TELEGRAPH RD SUITE 408 BINGHAM FARMS, MI 48025 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 11.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Float revenue; Contract Administrator; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 12 | — | $354K |
| BETH W. WIERENGA AGENT/BROKER | Other commissions; Insurance agents and brokers; Other fees; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | 300 OTTAWA NW, SUITE 301 GRAND RAPIDS, MI 495032336 | $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 | 662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 672 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,139 | $442K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,176 | $37K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 555 | $173K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 550 | $29K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 555 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,176 | — |
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.