Form 5500 · Employee benefit plan · GRAND RAPIDS, MI
MEIJER, INC.
The filing calls this plan MEIJER EXECUTIVE HEALTH PLAN.
MEIJER, INC. of GRAND RAPIDS, MI insures health, dental and vision coverage for its employees, per Schedule A of its Form 5500. Its broker of record is VALERIE MCCOY. Coverage is written through BLUE CROSS BLUE SHIELD OF MICHIGAN. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 38-1274536 · plan 510 · plan year 2025, filed Oct 31, 2025
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How this plan is funded
Both, as reported
The filing reports both insurance premium and benefits paid from the plan's own money, and the two amounts do not line up.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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 1 insured contract covering health, dental and vision; the largest, with BLUE CROSS BLUE SHIELD OF MICHIGAN, covers 270 people.
Reported premium across the insured contracts is $3,179,161, with $45,777 in disclosed broker commissions — about 1.4% of premium.
The most recent policy period ended in December, and the plan year ends February 1. Group contracts typically renew on that annual cycle.
At 98 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health, Dental, Vision | 270 | Jan 1, 2025 | $3,179,161 | $45,777 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 624034. For the contract year on this filing, the carrier reported $3,179,161 in premium earned and $4,320,496 in claims incurred. Dividing one by the other gives 136%.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 624034 reported $689,637 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: 32,979 employees, 514 recordable cases, 4,704 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule I
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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