| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHELE L BOLSER3 | PO BOX 2999 FARMINGTON HILLS, MI 48333 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $158K | — | $158K | 2.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $483K | $23K | $505K | 11.96% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY | 186 KING GEORGE ST DANIEL ISLAND, SC 29492 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $247K | $14K | $261K | 13.07% |
| NATIONAL INSURANCE MARKETS INC3 Filed as: NATIONAL INSURANCE MARKETS INC. | 915 SAXONBURG BLVD, STE 217 PITTSBURGH, PA 15223 | HIGHMARK INC. | $27K | — | $27K | 1.96% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY | 186 KING GEORGE ST DANIEL ISLAND, SC 29492 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.73% |
| MICHELE L BOLSER3 | PO BOX 2999 FARMINGTON HILLS, MI 48333 | BLUE CARE NETWORK OF MICHIGAN | $8K | — | $8K | 6.58% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY | 186 KING GEORGE ST DANIEL ISLAND, SC 29492 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $371 | $7K | 13.88% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 200 LIBERTY ST NEW YORK, NY 10281 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | $516 | — | $516 | 5.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $53 | $53 | 2.14% |
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 | 10,131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 95 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 539 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,765 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 8 carriers) | UNITED STATES FIRE INSURANCE COMPANY | 1,101 | $22.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 8,076 | $2.0M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 8,076 | $2.0M |
| Life insurance(3 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 8,076 | $2.5M |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 74 | $51K |
| Long-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,202 | $517K |
| Prescription drug(6 contracts, 6 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,047 | $12.3M |
| Other(5 contracts, 4 carriers) | UNITED STATES FIRE INSURANCE COMPANY | 8,076 | $13.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,076 | — |
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.