Form 5500 · Employee benefit plan · AFTON, MI
TF-R INC.
The filing calls this plan TUBE FAB/ROMAN ENG CO (TF-R) WELFARE BENEFIT PLAN.
TF-R INC. of AFTON, MI insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BRIAN T COTE. Coverage is written through BLUE CARE NETWORK OF MICHIGAN and 2 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-1864939 · plan 502 · plan year 2025, filed Feb 19, 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 3 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CARE NETWORK OF MICHIGAN, covers 183 people.
Reported premium across the insured contracts is $1,174,965, with $48,399 in disclosed broker commissions — about 4.1% of premium.
The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.
BRIAN T COTE is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including BLUE CARE NETWORK OF MICHIGAN, METROPOLITAN LIFE INSURANCE COMPANY and BLUE CROSS BLUE SHIELD OF MICHIGAN. 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 | 183 | Sep 1, 2025 | $1,060,994 | $34,081 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Life, Disability | 209 | Sep 1, 2025 | $80,775 | $12,017 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Health, Vision | 171 | Sep 1, 2025 | $33,196 | $2,301 |
Premium and claims on these contracts
BLUE CARE NETWORK OF MICHIGAN, contract 181861. For the contract year on this filing, the carrier reported $1,060,994 in premium earned and $624,217 in claims incurred. Dividing one by the other gives 59%.
BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 181861. For the contract year on this filing, the carrier reported $33,196 in premium earned and $8,181 in claims incurred. Dividing one by the other gives 25%.
- BLUE CARE NETWORK OF MICHIGAN, contract 181861 reported $294,547 in retention.
- BLUE CROSS BLUE SHIELD OF MICHIGAN, contract 181861 reported $7,557 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: 120 employees, 3 recordable cases, 31 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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