Form 5500 · Employee benefit plan · ATLANTIC MINE, MI
SOMERO ENTERPRISES, INC.
The filing calls this plan SOMERO ENTERPRISES, INC. EMPLOYEE BENEFITS PLAN.
SOMERO ENTERPRISES, INC. of ATLANTIC MINE, MI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is HEATHER A MOSHER. Coverage is written through BLUE CROSS BLUE SHIELD 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 20-3225968 · plan 503 · plan year 2025, filed May 27, 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.
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 CROSS BLUE SHIELD OF MICHIGAN, covers 370 people.
Reported premium across the insured contracts is $2,870,954, with $123,869 in disclosed broker commissions — about 4.3% 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.
HEATHER A MOSHER is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF MICHIGAN, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, DELTA DENTAL OF MICHIGAN and EYEMED VISION CARE. BLUE CROSS BLUE SHIELD 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 | 370 | Jan 1, 2026 | $2,450,325 | $72,368 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 126 | Jan 1, 2026 | $211,850 | $35,570 |
| DELTA DENTAL OF MICHIGAN | Dental | 369 | Jan 1, 2026 | $173,753 | $11,835 |
| EYEMED VISION CARE | Vision | 289 | Jan 1, 2026 | $22,109 | $2,494 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | 9 | Jan 1, 2026 | $12,917 | $1,602 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 401817. For the contract year on this filing, the carrier reported $2,450,325 in premium earned and $2,460,078 in claims incurred. Dividing one by the other gives 100%.
DELTA DENTAL OF MICHIGAN, contract 0005382. For the contract year on this filing, the carrier reported $162,127 in premium earned and $135,017 in claims incurred. Dividing one by the other gives 83%.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 401817 reported $731,923 in retention.
- DELTA DENTAL OF MICHIGAN, contract 0005382 reported $26,280 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: 127 employees, 2 recordable cases, 62 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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