| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A KELLEHER3 Filed as: ROBERT B ARTINIAN | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $42K | $55K | 13.92% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.57% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC. | 901 WILSHIRE DRIVE TROY, MA 48084 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 5.67% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DR MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $61 | $11K | 9.99% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DR TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $500 | $10K | 8.79% |
| DIANNA LYNN ATCHISON3 | 15130 SNOWBERRY CT SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $410 | $9K | 8.62% |
| JASON RODERICK3 | 2130 28TH ST SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $26 | $7K | 6.13% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $155 | $5K | 4.39% |
| W F HILL AND ASSOCIATES INC3 | 600 WEST LAFAYETTE DETROIT, MI 48226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $3K | 3.05% |
| BALLARD FINANCIAL LLC3 | 17441 MADISON ST SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $246 | $3K | 2.91% |
| DEREK GENE BALLARD3 | 17441 MADISON ST SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $30 | $2K | 2.27% |
| CHARLES ALLEN PINKERTON3 | 2653 CADES COVE BRIGHTON, MI 48114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $452 | $204 | $656 | 0.61% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DR MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $219 | $155 | $374 | 0.35% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC. | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | EYE MED | $3K | — | $3K | 9.91% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DR MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $9 | $2K | 10.73% |
| DIANNA LYNN ATCHISON3 | 15130 SNOWBERRY CT SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $56 | $1K | 8.68% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DR TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $67 | $1K | 8.66% |
| JASON RODERICK3 | 2130 28TH ST SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $5 | $1K | 8.20% |
| SHAWNEENA MERCADO OVERLY3 | 3958 PARKER'S FRY FORT MILL, SC 29715 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $353 | $35 | $388 | 2.65% |
| BALLARD FINANCIAL LLC3 | 17441 MADISON ST SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $279 | $24 | $303 | 2.07% |
| DEREK GENE BALLARD3 | 17441 MADISON ST SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $259 | $3 | $262 | 1.79% |
| W F HILL AND ASSOCIATES INC3 Filed as: W F HILL AND ASSOCIATES | 600 WEST LAFAYETTE DETROIT, MI 48226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $86 | $163 | 1.11% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $4 | $136 | 0.93% |
| CHARLES ALLEN PINKERTON3 | 2653 CADES COVE BRIGHTON, MI 48114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $18 | $59 | 0.40% |
| 3C HOLDINGS INC3 | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $18 | $45 | 0.31% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $8 | $35 | 0.24% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DR MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $4 | $9 | 0.06% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC. | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $135 | $1K | 11.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Insurance services; Consulting (general); Contract Administrator; Direct payment from the plan; Claims processing; Other fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $182K |
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 | 234 | 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) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 553 | $135K |
| Vision | EYE MED | 492 | $29K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 279 | $119K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 119 | $123K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 11 | $15K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 234 | $398K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 279 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 553 | — |
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.