| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE STREET ADVISORS LLC3 | 244 N ROSE ST KALAMAZOO, MI 49007 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 6.82% |
| GREGORY A. HAGBOM3 Filed as: GREGORY C THOMPSON | 3448 WENDOVER RD TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $49 | $5K | 8.85% |
| MICHELLE LIVINGSTON3 | 18211 DORSET ST SOUTHFIELD, MI 48075 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $431 | — | $431 | 0.75% |
| KENNETH JAMES BOWERY3 | 2083 PINECROFT DR CANTON, MI 48188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $240 | $3 | $243 | 0.42% |
| RAY SCOTT3 | 5318 INDIAN TRAIL YPSILANTI, MI 48197 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.13% |
| W F HILL AND ASSOCIATES INC3 | 600 WEST LAFAYETTE DETROIT, MI 48226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $19 | $51 | 0.09% |
| WADYE T GALLANT3 | 18151 RAMSGATE LATHRUP VILLAGE, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $9 | $34 | 0.06% |
| JAMES A SMAARDYK3 Filed as: JAMES M TAYLOR | 3016 SPRING HILL PKWY SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CENTER GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| MARY LOU TAYLOR3 | 3016 SPRING HILL PKWY SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Contract Administrator; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other fees; Direct payment from the plan Service code 12 | — | $167K |
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 | 326 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 326 | $157K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 326 | $157K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 326 | $157K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 326 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.