| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $33K | — | $33K | 3.06% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $28K | — | $28K | 4.00% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD, SUITE 150 GRAND RAPIDS, MI 495448214 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $32K | $2K | $34K | 5.02% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $20K | — | $20K | 3.28% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $33K | — | $33K | 5.84% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $23K | — | $23K | 5.83% |
| SPECTRUM BENEFITS LLC3 | 721 THREE MILE RD, SUITE 150 GRAND RAPIDS, MI 495448214 | BLUE CARE NETWORK OF MICHIGAN | $22K | — | $22K | 5.42% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | BLUE CARE NETWORK OF MICHIGAN | $10K | — | $10K | 5.95% |
| KYLE R. HARTMAN3 Filed as: KYLE R HARTMAN | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 3.40% |
| WALLY J. MARTYNIEK3 Filed as: WALLY J MARTYNIEK | 721 THREE MILE RD STE 150 GRAND RAPIDS, MI 495448214 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | $266 | $3K | 2.17% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 495140167 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1K | — | $1K | 1.07% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD, SUITE 150 GRAND RAPIDS, MI 495448214 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $147 | $6K | 5.14% |
| SPECTRUM BENEFITS LLC3 | 721 3 MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $809 | $809 | 1.11% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | NATIONAL GUARDIAN LIFE | $3K | — | $3K | 4.43% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $2K | — | $2K | 2.62% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 495448224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.38% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $48 | $4K | 9.08% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $564 | — | $564 | 1.38% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 11.40% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 495448224 | VISION SERVICE PLAN | $791 | — | $791 | 7.78% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 495448224 | VISION SERVICE PLAN | $655 | — | $655 | 9.85% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $170 | — | $170 | 2.96% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE ROAD NW, SUITE 150 GRAND RAPIDS, MI 49544 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $307 | — | $307 | 11.00% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS, LLC | 721 THREE MILE RD NW, SUITE 150 GRAND RAPIDS, MI 495448224 | METROPOLITAN LIFE INSURANCE COMPANY | $140 | $48 | $188 | 19.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 N/A | Consulting (general); Float revenue; Claims processing; Direct payment from the plan; Insurance services; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $69K |
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 | 730 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 737 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(15 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 327 | $5.1M |
| Dental(5 contracts, 5 carriers) | BLUE CARE NETWORK OF MICHIGAN | 162 | $441K |
| Vision(2 contracts) | VISION SERVICE PLAN | 122 | $17K |
| Life insurance(6 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $264K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $118K |
| Long-term disability(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $225K |
| Prescription drug(15 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 327 | $5.1M |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 299 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.