| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY J HALL3 | 25900 W 11 MILE ROAD STE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | $56K | — | $56K | 2.61% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE ROAD STE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | — | $5K | $5K | 0.22% |
| AMY J HALL3 | 25900 W. 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $48K | — | $48K | 2.43% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W. 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 0.19% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $31K | $11K | $42K | 10.30% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38K | $7K | $46K | 60.80% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN, LLC | 25900 W 11 MILE ROAD STE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $496 | $11K | 15.00% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | — | $1K | 2.81% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN, LLC | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $406 | — | $406 | 0.82% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | -$44 | — | -$44 | -0.09% |
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 | 642 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 48 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 411 | $4.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 703 | $405K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 806 | $50K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 703 | $405K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 703 | $405K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 411 | $4.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 761 | $480K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 806 | — |
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.