| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES W WATSON3 | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $8K | $23K | 5.38% |
| COLDBROOK INSURANCE GROUP3 Filed as: COLDBROOK INSURANCE GROUP LLC | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 2.99% |
| COLDBROOK INSURANCE GROUP | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $1K | $7K | 10.61% |
| COLDBROOK INSURANCE GROUP | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $916 | $5K | 118.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Contract Administrator; Direct payment from the plan; Claims processing; Float revenue; Insurance services; Consulting (general) Service code 12 | — | $0 |
| COLDBROOK INSURANCE GROUP LLC BROKER | Insurance brokerage commissions and fees; Other fees; Other commissions; Insurance agents and brokers; Non-monetary compensation Service code 22 | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | $0 |
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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $426K |
| Dental | DELTA DENTAL OF MICHIGAN | 350 | $93K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $426K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 79 | $64K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 79 | $64K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 74 | $5K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $426K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $426K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.