| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHELLE R. STOUFFER3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $27K | $2K | $30K | 1.54% |
| MICHELLE R. STOUFFER3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $7K | $512 | $7K | 1.93% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MICHIGAN LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | DELTA DENTAL OF MICHIGAN | $5K | $315 | $5K | 3.07% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $12K | 12.01% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $3K | $0 | $3K | 10.80% |
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 | 247 | 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) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 343 | $2.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 483 | $158K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 462 | $27K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 249 | $101K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 249 | $101K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 343 | $2.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 249 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 483 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.