| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN J BALTAS3 | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $19K | $84K | $103K | 18.67% |
| MARC J LASCESKI3 Filed as: MARC S BYRNES | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.60% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE E CLEVELAND, OH 44114 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 3.28% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $9K | — | $9K | 12.00% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $8K | — | $8K | 12.00% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 10.00% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $1K | — | $1K | 12.00% |
| JAMES A SMAARDYK Filed as: JAMES M. TAYLOR | 1012 SUGARLOAF RESERVE DR. DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | — | $103 | 1.54% |
| MARY LOU TAYLOR | 1012 SUGARLOAF RESERVE DR. DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 1.03% |
| LAURA ANN MARSHALL | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.51% |
| DAVID L SMELCER Filed as: DAVID L. SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.34% |
| DIANNA LYNN ATCHISON | 15130 SNOWBERRY CT. SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Float revenue; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | — | $238K |
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 | 421 | 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) | 421 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 302 | $554K |
| Dental | DELTA DENTAL OF MICHIGAN | 651 | $231K |
| Vision(2 contracts) | SVS VISION MANAGED CARE, INC. | 120 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 390 | $79K |
| Short-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 551 | $157K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 171 | $45K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 302 | $554K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 302 | $554K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 13 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.