| 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 | $63K | $0 | $63K | 2.71% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.05% |
| MICHELLE R. STOUFFER3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $11K | $0 | $11K | 2.50% |
| TRICOAST ADVISORS LLC3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $0 | $210 | $210 | 0.05% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | DELTA DENTAL OF MICHIGAN | $8K | $0 | $8K | 4.74% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES LLC | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $5K | $17K | 13.26% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $3K | $0 | $3K | 9.06% |
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 | 301 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 306 | 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 | 396 | $2.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 497 | $162K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 499 | $28K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $130K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $130K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 396 | $2.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 499 | — |
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.