| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SBR SERVICES LLC3 Filed as: SBR SERVICES, LLC | 2839 PACES FERRY ROAD, SE SUITE 830 ATLANTA, GA 30339 | TOKIO MARINE HCC - STOP LOSS GROUP | $7K | — | $7K | 1.20% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE E CLEVELAND, OH 44114 | DELTA DENTAL OF MICHIGAN | $12K | $523 | $13K | 5.32% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | — | $21K | 8.86% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 2734 N. MILDRED AVE., 3 CHICAGO, IL 60618 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.21% |
| THE JAMES B OSWALD COMPANY Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE E STE 1500 CLEVELAND, OH 441142544 | VSP VISION SERVICE PLAN | $1K | — | $1K | 4.50% |
| STEVEN J BALTAS3 | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $52K | — | $52K | — |
| MARC J LASCESKI3 Filed as: MARC S LASCESKI | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $49K | — | $49K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Float revenue; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Insurance services; Contract Administrator; Claims processing Service code 12 | — | $284K |
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 447 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TOKIO MARINE HCC - STOP LOSS GROUP | 308 | $612K |
| Dental | DELTA DENTAL OF MICHIGAN | 619 | $237K |
| Vision | VSP VISION SERVICE PLAN | 214 | $29K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 406 | $236K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 406 | $236K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 406 | $236K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 308 | $0 |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC - STOP LOSS GROUP | 307 | $612K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 406 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 619 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.