Form 5500 · Employee benefit plan · GRAND RAPIDS, MI
SAFARI CIRCUITS INC.
The filing calls this plan SAFARI CIRCUITS EMPLOYEE BENEFIT PLAN.
SAFARI CIRCUITS INC. of GRAND RAPIDS, MI insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is WALLY J MARTYNIEK. Coverage is written through BLUE CARE NETWORK OF MICHIGAN and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-3491050 · plan 501 · plan year 2025, filed Jul 30, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 5 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CARE NETWORK OF MICHIGAN, covers 128 people.
Reported premium across the insured contracts is $1,121,859, with $36,741 in disclosed broker commissions — about 3.3% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
WALLY J MARTYNIEK is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including BLUE CARE NETWORK OF MICHIGAN, BLUE CROSS BLUE SHIELD OF MICHIGAN, DELTA DENTAL OF MICHIGAN and DEARBORN LIFE INSURANCE COMPANY. BLUE CARE NETWORK OF MICHIGAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CARE NETWORK OF MICHIGAN | Health | 128 | Jan 1, 2026 | $883,274 | $23,727 |
| DEARBORN LIFE INSURANCE COMPANY | Life, Disability | 80 | Jan 1, 2026 | $58,788 | $6,389 |
| DELTA DENTAL OF MICHIGAN | Dental | 148 | Jan 1, 2026 | $63,312 | $2,990 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health | 2 | Jan 1, 2026 | $108,044 | $2,577 |
| EYEMED VISION CARE | Vision | 130 | Jan 1, 2026 | $8,441 | $1,058 |
Premium and claims on these contracts
BLUE CARE NETWORK OF MICHIGAN, contract 281747. For the contract year on this filing, the carrier reported $883,274 in premium earned and $521,916 in claims incurred. Dividing one by the other gives 59%.
DELTA DENTAL OF MICHIGAN, contract 6936. For the contract year on this filing, the carrier reported $62,827 in premium earned and $46,403 in claims incurred. Dividing one by the other gives 74%.
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 281747. For the contract year on this filing, the carrier reported $108,044 in premium earned and $89,973 in claims incurred. Dividing one by the other gives 83%.
- BLUE CARE NETWORK OF MICHIGAN, contract 281747 reported $201,067 in retention.
- DELTA DENTAL OF MICHIGAN, contract 6936 reported $10,593 in retention.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 281747 reported $25,342 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.
How this plan compares
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