| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLDBROOK INSURANCE GROUP3 Filed as: COLDBROOK INSURANCE GROUP, LLC | 2000 OAK INDUSTRAIL DR NE STE B GRAND RAPIDS, MI 49505 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | $8K | $21K | 5.65% |
| COLDBROOK INSURANCE GROUP3 Filed as: COLDBROOK INSURANCE GROUP, LLC | 2000 OAK INDUSTRAIL DR NE STE B GRAND RAPIDS, MI 49505 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 6.30% |
| COLDBROOK INSURANCE GROUP3 Filed as: COLDBROOK INSURANCE GROUP, LLC | 2000 OAK INDUSTRAIL DR NE STE B GRAND RAPIDS, MI 49505 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $216 | $2K | 11.35% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $891 | $891 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Insurance services; Contract Administrator; Other fees; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $76K |
| COLDBROOK INSURANCE GROUP | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other commissions; Other fees Service code 22 | — | $21K |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 69 | $380K |
| Dental | DELTA DENTAL OF MICHIGAN | 174 | $48K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 69 | $380K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $18K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $18K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $18K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 69 | $380K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 69 | $380K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.