| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFFILIATED AGENCIES LLC3 | 5925 MERIDIAN BOULEVARD BRIGHTON, MI 48116 | TOTAL HEALTH CARE USA, INC. | $18K | — | $18K | 4.23% |
| AFFILIATED AGENCIES LLC3 Filed as: AFFILIATED AGENCIES | 5925 MERIDIAN BOULEVARD SUITE 300 BRIGHTON, MI 48116 | BLUE CARE NETWORK OF MICHIGAN | $14K | — | $14K | 4.25% |
| AFFILIATED AGENCIES LLC3 | 5925 MERIDIAN BOULEVARD SUITE 300 BRIGHTON, MI 48116 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $6K | $17K | 14.71% |
| ANTHONY JOSEPH MOTTER3 Filed as: ANTHONY LLOYD | 1205 LOUISIANA AVENUE #441 PERRYSBURG, OH 43552 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27K | — | $27K | 39.27% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16K | — | $16K | 24.40% |
| CUSTOM BENEFITS INSURANCE GROUP INC3 | 4204 MARTIN ROAD SUITE A WALLED LAKE, MI 48390 | EYEMED VISION CARE | $841 | — | $841 | 19.35% |
| ANTHONY JOSEPH MOTTER3 Filed as: ANTHONY M LLOYD INC. DBA STRATEGIC | 11201 SANDUSKY STREET SUITE 201 PERRYSBURG, OH 43551 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $554 | — | $554 | 15.84% |
| STRATEGIC BENEFITS3 Filed as: STRATEGIC SERVICES INC. | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $503 | — | $503 | 14.38% |
| MONTEAL R BROWNE3 | 591 WEST HILLDALE HIGHLAND PARK, MI 48203 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $56 | — | $56 | 1.60% |
| ANTHONY P PETRILL3 | 2700 OLD STABLES DRIVE CELINA, TX 75009 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $39 | — | $39 | 1.12% |
| KELLY M TIMMONS3 | 4205 OXFORD DRIVE COLUMBUS, OH 43220 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $35 | — | $35 | 1.00% |
| DENNIS W MCVITTIE JR3 | 43749 DORISA COURT NORTHVILLE, MI 48167 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | — | $25 | 0.71% |
| BRUCE ABRAMSON3 | 1055 SHERBROOKE STREET COMMERCE TOWNSHIP, MI 48383 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $12 | — | $12 | 0.34% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | TOTAL HEALTH CARE USA, INC. | 117 | $831K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $117K |
| Vision(2 contracts, 2 carriers) | TOTAL HEALTH CARE USA, INC. | 146 | $434K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $117K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $117K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $117K |
| Prescription drug(2 contracts, 2 carriers) | TOTAL HEALTH CARE USA, INC. | 117 | $764K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 183 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.