| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY J HALL3 Filed as: AMY J. HALL | 25900 W. ELEVEN MILE RD. STE 210 SOUTHFIELD, MI 48034 | PRIORITY HEALTH | $6.0M | — | $6.0M | 450.00% |
| J.S. CLARK AGENCY, INC.3 Filed as: J.S. CLARK AGENCY INC. | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 4.68% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE RD. STE. 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 16.20% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE RD. SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.28% |
| AMY J HALL3 Filed as: AMY J. HALL | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | PRIORITY HEALTH INSURANCE COMPANY | $1K | $0 | $1K | 4.43% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE RD. STE. 210 SOUTHFIELD, MI 48304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 15.76% |
| J.S. CLARK AGENCY, INC.3 | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | $0 | $2K | 10.00% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE RD. SUITE 210 SOUTHFIELD, MI 49304 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $875 | $4K | 19.99% |
| J.S. CLARK AGENCY, INC.3 Filed as: J.S. CLARK AGENCY INC. | 25900 W 11 MILE RD SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $527 | $0 | $527 | 4.60% |
| AMY J HALL3 Filed as: AMY J. HALL | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | PRIORITY HEALTH | $0 | $0 | $0 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 174 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 320 | $1.4M |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 266 | $73K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 144 | $18K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $27K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $28K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $37K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.