| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLY J. MARTYNIEK3 Filed as: WALLY J. MARTYNEK | 721 THREE MILE RD STE 150 GRAND RAPIDS, MI 495448214 | BLUE CARE NETWORK OF MICHIGAN | $53K | $5K | $58K | 3.54% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $30K | — | $30K | 3.12% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD STE 150 GRAND RAPIDS, MI 495448214 | BLUE CARE NETWORK OF MICHIGAN | $31K | — | $31K | 3.84% |
| WALLY J. MARTYNIEK3 Filed as: WALLY MARTYNIEK | 721 THREE MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $33K | — | $33K | 4.04% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD STE 150 GRAND RAPIDS, MI 495448214 | BLUE CARE NETWORK OF MICHIGAN | $22K | $830 | $23K | 4.08% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE ROAD STE 150 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | $705 | $14K | 3.08% |
| WALLY J. MARTYNIEK3 Filed as: WALLY MARTYNIEK | 721 THREE MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $13K | — | $13K | 3.00% |
| SPECTRUM BENEFITS LLC3 | 721 THREE MILE ROAD NW STE 150 GRAND RAPIDS, MI 49544 | DEARBORN LIFE INSURANCE COMPANY | $301 | — | $301 | 0.14% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE ROAD STE 150 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 3.38% |
| WALLY J. MARTYNIEK3 Filed as: WALLY MARTYNIEK | 721 THREE MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH INSURANCE COMPANY | $2K | — | $2K | 3.00% |
| WALLY J. MARTYNIEK3 | 721 THREE MILE RD NW, STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $600 | — | $600 | 0.86% |
| WALLY J. MARTYNIEK3 Filed as: WALLY MARTYNIEK | 721 THREE MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | PRIORITY HEALTH | $450 | — | $450 | 0.78% |
| SPECTRUM BENEFITS LLC3 Filed as: SPECTRUM BENEFITS | 721 THREE MILE ROAD GRAND RAPIDS, MI 49544 | EYEMED VISION CARE | $5K | — | $5K | 11.12% |
| SPECTRUM BENEFITS LLC3 | 721 THREE MILE ROAD NW STE 150 GRAND RAPIDS, MI 49544 | DELTA DENTAL OF MICHIGAN | $811 | — | $811 | 10.00% |
| SPECTRUM BENEFITS LLC3 | 721 THREE MILE RD NW STE 150 GRAND RAPIDS, MI 49544 | METROPOLITAN LIFE INSURANCE COMPANY | $227 | — | $227 | 13.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Direct payment from the plan; Float revenue; Insurance services; Consulting (general) Service code 12 | — | $18K |
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 | 542 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 54 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 597 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(12 contracts, 4 carriers) | BLUE CARE NETWORK OF MICHIGAN | 479 | $6.1M |
| Dental(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 479 | $533K |
| Vision | EYEMED VISION CARE | 714 | $45K |
| Life insurance(4 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 651 | $300K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 651 | $208K |
| Long-term disability(4 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 651 | $263K |
| Prescription drug(11 contracts, 4 carriers) | BLUE CARE NETWORK OF MICHIGAN | 479 | $6.0M |
| Other(3 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 651 | $262K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 714 | — |
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."
No prospect flags tripped on this filing.