| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL BUCK3 | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | — | $15K | 3.49% |
| SALUS GROUP3 | — | HARTFORD LIFE INSURANCE | $4K | — | $4K | 10.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Insurance services; Float revenue; Other fees; Claims processing; Consulting (general) Service code 12 | — | $464K |
| TIC INT'L EIN 13-2600875 NONE | Contract Administrator; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $109K |
| JEFF LESSER NONE | Legal; Direct payment from the plan Service code 29 | 30300 NORTHWESTERN HIGHWAY STE 32 FARMINGTON HILLS, MI 48334 | $57K |
| THE SALUS GROUP EIN 20-2024076 NONE | Non-monetary compensation; Direct payment from the plan; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $38K |
| DELTA DENTAL EIN 38-1791480 NONE | Direct payment from the plan; Claims processing; Other fees; Insurance services; Contract Administrator; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $27K |
| COMERICA BANK EIN 38-0477375 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $18K |
| UAS NONE | Direct payment from the plan; Actuarial Service code 11 | 11590 NORTH MERIDAN SUITE #610 CARMEL, IN 460324529 | $10K |
| WRUBEL WESLEY AND COMPANY C.P.A.'S EIN 38-2574238 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $9K |
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 | 547 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 82 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 629 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 1,488 | $362K |
| Life insurance | HARTFORD LIFE INSURANCE | 599 | $35K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 594 | $428K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,488 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.