| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR CORPORATION3 | P.O. BOX 6392 GRAND RAPIDS, MI 49516 | ARDELLIS INSURANCE LTD | $76K | — | $76K | 17.97% |
| CAMERON M KENNEDY3 | 400 WEST FOURTH STREET SUITE 300 ROYAL OAK, MI 48067 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | — | $14K | 4.94% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD STE 400 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT INC | 35735 MOUND RD STERLING HEIGHTS, MI 48310 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $264 | $264 | 0.09% |
| CAMERON M KENNEDY3 Filed as: CAMERON KENNEDY | CAMBRIDGE CONSULTING GROUP LLC 400 WEST FOURTH STREET SUITE 300 ROYAL OAK, MI 48067 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.65% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 WEST FOURTH STREET SUITE 300 ROYAL OAK, MI 48067 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 33.87% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $69 | $69 | 0.19% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 WEST FOURTH STREET SUITE 300 ROYAL OAK, MI 48067 | EYEMED VISION CARE | $3K | — | $3K | 9.09% |
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 | 2,700 | 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) | 2,700 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 62 | $284K |
| Dental | DELTA DENTAL OF MICHIGAN | 626 | $176K |
| Vision | EYEMED VISION CARE | 556 | $30K |
| Life insurance(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 400 | $24K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 96 | $36K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 115 | $19K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 62 | $284K |
| Stop-loss / reinsurancereinsurance | ARDELLIS INSURANCE LTD | 329 | $422K |
| Other(5 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 400 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 626 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.