| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $19K | — | $19K | 0.56% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $10K | — | $10K | 0.27% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $105K | — | $105K | 10.98% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $52K | — | $52K | 5.49% |
| MACQUEEN & ASSOCIATES LLC Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | THE UNION LABOR LIFE INSURANCE COMPANY | $37K | — | $37K | 7.50% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | MUTUAL OF OMAHA | $27K | $4K | $31K | 11.40% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $7K | — | $7K | 2.88% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 1.44% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $3K | — | $3K | 2.73% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $2K | — | $2K | 1.41% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 3.07% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 1.62% |
| ROBERT EFROS3 | 7300 N. BRIARCLIFF KNOLL WEST BLOOMFIELD, MI 48322 | THE UNION LABOR LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $500 | — | $500 | 2.33% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $250 | — | $250 | 1.17% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $700 | — | $700 | 3.27% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $400 | — | $400 | 1.87% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $900 | — | $900 | 4.24% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $450 | — | $450 | 2.12% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 2.79% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $150 | — | $150 | 1.40% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 3.22% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $150 | — | $150 | 1.61% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $200 | — | $200 | 4.29% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $100 | — | $100 | 2.15% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $200 | — | $200 | 4.57% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $100 | — | $100 | 2.29% |
| BENESYS INC5 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 17.39% |
| TMR & ASSOCIATES3 | 601 ABBOTT STREET DETROIT, MI 48226 | HUMANA INSURANCE COMPANY | $150 | — | $150 | 8.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA INSURANCE COMPANY EIN 39-1263473 NONE | Insurance services Service code 23 | 500 WEST MAIN STREET LOUISVILLE, KY 40202 | $4.7M |
| ENVISION PHARMACEUTICAL EIN 05-0570786 NONE | Contract Administrator; Claims processing Service code 12 | 2181 E. AURORA RD STE 201 TWINSBURG, OH 44087 | $933K |
| MUTUAL OF OMAHA EIN 47-0322111 NONE | Insurance services Service code 23 | 3300 MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | $273K |
| DELTA DENTAL PLAN OF MICHIGAN EIN 38-1791480 NONE | Insurance services Service code 23 | PO BOX 30416 LANSING, MI 489097916 | $198K |
| THE UNION LABOR LIFE INSURANCE CO EIN 13-1423090 NONE | Insurance services Service code 23 | ONE STREET NORTHWEST WASHINGTON, DC 20001 | $159K |
| BENESYS INC EIN 38-3507129 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | $136K |
| HEALTH ALLIANCE PLAN OF MICHIGAN EIN 38-2242827 NONE | Contract Administrator Service code 13 | 2850 W. GRAND BLVD DETROIT, MI 48202 | $43K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Insurance services Service code 23 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $25K |
| PREMIER HEALTHCARE EXCHANGE EIN 86-1040704 NONE | Contract Administrator Service code 13 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $21K |
| FIFTH THIRD BANK EIN 31-1051736 NONE | Custodial (securities) Service code 19 | 1000 TOWN CENTER STE 1500 SOUTHFIELD, MI 48075 | $13K |
| WALTER, BOESKY & ASSOCIATES P.C. EIN 38-3629743 NONE | Accounting (including auditing) Service code 10 | 17320 W. 12 MILE ROAD STE 200 SOUTHFIELD, MI 480762105 | $12K |
| SULLIVAN WARD ASHER AND PATTON PC EIN 38-1956491 NONE | Legal Service code 29 | 25800 NORTHWESTERN HIGHWAY SOUTHFIELD, MI 48075 | $11K |
| AMERICARE MEDICAL INC. EIN 38-2364792 NONE | Other services Service code 49 | 1938 WOODSLEE DRIVE TROY, MI 48083 | $11K |
| MACQUEEN INSURANCE GROUP EIN 20-0495393 NONE | Insurance services Service code 23 | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | $8K |
| ALAN D BILLER & ASSOCIATES EIN 94-2854958 NONE | Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD ROAD STE 230 MENLO PARK, CA 94025 | $8K |
| HEALTH DESIGN ENTERPRISES LLC EIN 38-3607439 NONE | Contract Administrator Service code 13 | 1550 E BELTLINE SE GRAND RAPIDS, MI 49506 | $8K |
| AMERICAN GRAPHICS EIN 38-2090931 NONE | Copying and duplicating Service code 36 | 34895 GROSEBECK HIGHWAY CLINTON TOWNSHIP, MI 48035 | $6K |
| WORK LIFE STRATEGIES EIN 80-0178558 NONE | Consulting (pension) Service code 17 | PO BOX 670444 DALLAS, TX 75367 | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,171 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(14 contracts, 3 carriers) | HUMANA INSURANCE COMPANY | 927 | $5.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 5,394 | $1.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 925 | $140K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA | 1,105 | $359K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,596 | $497K |
| Other(3 contracts, 3 carriers) | HAP PREFERRED INC. | 4,373 | $632K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,394 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.