| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT J KROHL3 | 1283 XANADU CT BRIGHTON, MI 48114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $41K | — | $41K | 1.93% |
| ROBERT J. FARRIS3 Filed as: ROBERT J FARRIS | 26026 TELEGRAPH RD STE 100 SOUTHFIELD, MI 48033 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $22K | — | $22K | 1.04% |
| PROADVISOR INSURANCE AGY LLC3 | 26555 EVERGREEN RD STE 535 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.11% |
| PROADVISOR INSURANCE AGENCY LLC3 | 26026 TELEGRAPH #100 SOUTHFIELD, MI 48034 | GUARDIAN | $3K | $3K | $6K | 9.89% |
| DMC BENEFITS INC3 | 1485 PRINCE CHARLES AVE WEST LAKE, OH 44145 | GUARDIAN | $3K | — | $3K | 5.00% |
| ACTIVE BENEFITS CO3 Filed as: ACTIVE INSURANCE LLC | 2451 S. INDUSTRIAL HWY ANN ARBOR, MI 48104 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 7.78% |
| RALPH C WILSON AGENCY INC3 Filed as: RALPH C WILSON AGCY INC | PO BOX 5069 SOUTHFIELD, MI 48086 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 3.05% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | PO BOX 5069 SOUTHFIELD, MI 48086 | UNITEDHEALTHCARE INSURANCE COMPANY | $677 | — | $677 | 1.13% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $2.1M |
| Dental | GUARDIAN | 129 | $63K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $2.1M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $60K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $60K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $60K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $2.1M |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.