| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENESYS INC5 | 700 TOWER DR STE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $69K | $0 | $69K | 3.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON PARTNERS | 325 SENTRY PARKWAY #200 BLUE BELL, PA 19422 | GRANULAR INSURANCE COMPANY | — | $14K | $14K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. NONE | Contract Administrator; Direct payment from the plan Service code 13 | 700 TOWERS DRIVE SUITE 300 TROY, MI 48098 | $203K |
| AETNA NONE | Direct payment from the plan; Claims processing Service code 12 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $202K |
| BOLTON PARTNERS NORTHEAST, INC. NONE | Direct payment from the plan; Consulting (general) Service code 16 | 2277 HIGHWAY 33 TRENTON, NJ 08690 | $60K |
| DELTA DENTAL EIN 23-1667011 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $41K |
| FISCHER DORWART EIN 23-2247478 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $20K |
| PFM ASSET MANAGEMENT, LLC EIN 23-3087064 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $20K |
| ODONOGHUE & ODONOGHUE LLP NONE | Legal; Direct payment from the plan Service code 29 | 5301 WISCONSIN AVE., MW SUITE 800 WASHINGTON, DC 20015 | $12K |
| KANG HAGGERTY & FEYROT, LLC NONE | Legal; Direct payment from the plan Service code 29 | 123 S. BROAD STREET, SUITE 1670 PHILADELPHIA, PA 19109 | $11K |
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 | 966 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 760 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,726 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 760 | $1.8M |
| Stop-loss / reinsurancereinsurance | GRANULAR INSURANCE COMPANY | 1,019 | $466K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,019 | — |
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."
No prospect flags tripped on this filing.