| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE WASHINGTON, MI 48094 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | — | $26K | 2.20% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS | 7219 GRAND RIVER RD BRIGHTON, MI 48114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $398 | $398 | 0.03% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE WASHINGTON, MI 48904 | BLUE CARE NETWORK OF MICHIGAN | $8K | — | $8K | 2.35% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD SUITE 400 SOUTHFIELD, MI 48076 | BLUE CARE NETWORK OF MICHIGAN | $1K | — | $1K | 0.45% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS | 7219 GRAND RIVER RD BRIGHTON, MI 48114 | BLUE CARE NETWORK OF MICHIGAN | — | $127 | $127 | 0.04% |
| EXTERNAL AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $5K | — | $5K | 2.46% |
| MANAGING AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $1K | — | $1K | 0.50% |
| MICHIGAN PLANNERS, INC.3 Filed as: MICHIGAN PLANNERS INC | 59259 VAN DYKE RD WASHINGTON, MI 48094 | PRINCIPAL LIFE INSURANCE COMPANY | $21K | $578 | $22K | 14.83% |
| EXTERNAL AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 1.95% |
| MANAGING AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $331 | — | $331 | 0.33% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 4.78% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $1K | — | $1K | 4.36% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $988 | — | $988 | 4.74% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $597 | — | $597 | 4.75% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $585 | — | $585 | 4.66% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DILORENZO | 59259 VAN DYKE RD WASHINGTON, MI 48094 | DELTA DENTAL OF MICHIGAN | $414 | — | $414 | 4.72% |
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 | 168 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 229 | $1.8M |
| Dental(6 contracts) | DELTA DENTAL OF MICHIGAN | 107 | $132K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 350 | $147K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 350 | $147K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 350 | $147K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 350 | $147K |
| Prescription drug(4 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 229 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.