| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MICHIGAN INC. | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | $40K | $0 | $40K | 3.02% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | $8K | $27K | 21.74% |
| MICHELLE R. STOUFFER3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $0 | $4K | 4.57% |
| TRICOAST ADVISORS LLC3 Filed as: TRICOAST ADVISORS, LLC | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $805 | $805 | 1.02% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW, SUITE 101 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1 | $0 | $1 | 0.00% |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | 224 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 224 | $79K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 224 | $79K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $125K |
| Prescription drug | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | 224 | $1.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.