| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL C WALKER3 Filed as: MICHAEL G. BUCK | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | — | $13K | 3.50% |
| MICHAEL C WALKER3 Filed as: MICHAEL G. BUCK | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 4.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Float revenue; Consulting (general); Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Insurance services; Other fees Service code 12 | — | $460K |
| TIC INTERNATIONAL INC EIN 13-2600875 NONE | Direct payment from the plan; Accounting (including auditing); Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Participant communication; Copying and duplicating; Other services Service code 10 | — | $119K |
| JEFFREY LESSER NONE | Legal; Direct payment from the plan Service code 29 | 30300 NORTHWESTERN HIGHWAY STE. 32 FARMINGTON HILLS, MI 48334 | $60K |
| THE SALUS GROUP EIN 20-2024076 NONE | Non-monetary compensation; Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $38K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Consulting (general) Service code 12 | — | $27K |
| PNC BANK NONE | Direct payment from the plan; Other services; Other fees Service code 49 | ONE FINANCIAL PARKWAY KALAMAZOO, MI 49009 | $21K |
| COMERICA BANK EIN 38-0477375 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $20K |
| WRUBEL WESLEY AND COMPANY C.P.A.'S EIN 38-2574238 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $10K |
| UAS NONE | Actuarial; Direct payment from the plan Service code 11 | 11590 NORTH MERIDAN STE. # 610 CARMEL, IN 460324529 | $5K |
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 | 463 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 81 | $173K |
| Dental | DELTA DENTAL OF MICHIGAN | 1,364 | $283K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 620 | $29K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 463 | $370K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 620 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,364 | — |
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.