Form 5500 · Employee benefit plan · GRAND RAPIDS, MI
ADAC PLASTICS, INC.
The filing calls this plan ADAC AUTOMOTIVE EMPLOYEE BENEFITS PLAN.
ADAC PLASTICS, INC. of GRAND RAPIDS, MI spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is CHRISTOPHER M BOUSCHET. Coverage is written through DELTA DENTAL OF MICHIGAN and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 38-2085222 · plan 501 · plan year 2025, filed Jun 3, 2026
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1,931 other employer plans in Michigan have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 6 insured contracts covering health, dental, vision, life and disability; the largest, with DELTA DENTAL OF MICHIGAN, covers 1,249 people.
Reported premium across the insured contracts is $892,658, with $82,022 in disclosed broker commissions — about 9.2% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in May. The plan is on a split renewal cycle.
CHRISTOPHER M BOUSCHET is the broker of record on 1 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including DELTA DENTAL OF MICHIGAN, CONTINENTAL AMERICAN INSURANCE COMPANY, RELIASTAR LIFE INSURANCE COMPANY and BLUE CROSS BLUE SHIELD OF MICHIGAN. DELTA DENTAL OF MICHIGAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health, Vision | 1,078 | Jan 1, 2026 | $43,388 | $37,711 |
| CONTINENTAL AMERICAN INSURANCE COMPANY | Life, Disability | 837 | Jan 1, 2026 | $299,418 | $27,568 |
| RELIASTAR LIFE INSURANCE COMPANY | — | 498 | Jan 1, 2026 | $164,664 | $16,466 |
| FOUR EVER LIFE INS CO. | — | 30 | May 24, 2025 | $1,844 | $277 |
| DELTA DENTAL OF MICHIGAN | Dental | 1,249 | Jan 1, 2026 | $366,324 | $0 |
| PINE REST | — | 851 | Jan 1, 2026 | $17,020 | $0 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 239483. For the contract year on this filing, the carrier reported $43,388 in premium earned and $44,917 in claims incurred. Dividing one by the other gives 104%.
DELTA DENTAL OF MICHIGAN, contract 0006680. For the contract year on this filing, the carrier reported $366,324 in premium earned and $340,878 in claims incurred. Dividing one by the other gives 93%.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 239483 reported $8,193 in retention.
- DELTA DENTAL OF MICHIGAN, contract 0006680 reported $27,209 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 757 employees, 6 recordable cases, 9 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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