| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| T M R & ASSOCIATES, INC. Filed as: T M R & ASSOCIATES INC | 601 ABBOTT STREET DETROIT, MI 482262513 | HUMANA INSURANCE COMPANY | $73K | — | $73K | 2.02% |
| BENESYS INC | 700 TOWER DRIVE SUITE 300 TROY, MI 480982835 | HUMANA INSURANCE COMPANY | $73K | — | $73K | 2.02% |
| MACQUEEN & ASSOCIATES LLC Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | — | $30K | 10.00% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | THE UNION LABOR LIFE INSURANCE COMPANY | $8K | — | $8K | 7.50% |
| T M R & ASSOCIATES, INC. Filed as: T M R & ASSOCIATES INC | 601 ABBOTT STREET DETROIT, MI 482262513 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 1.77% |
| BENESYS INC | 700 TOWER DRIVE SUITE 300 TROY, MI 480982835 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 1.77% |
| HM LIFE INSURANCE COMPANY | 120 FIFTH AVENUE PITTSBURGH, PA 15222 | DAVIS VISION | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA INSURANCE CO EIN 39-1263473 NONE | Insurance services; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 5200 SOUTHPOINT DR LOUISVILLE, KY 40229 | $3.6M |
| DELTA DENTAL PLAN OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | PO BOX 30416 LANSING, MI 489097916 | $537K |
| METROPOLITAN LIFE INSURANCE CO EIN 13-5581829 NONE | Direct payment from the plan; Insurance services Service code 23 | 501 US HIGHWAY 22, 2ND FLOOR BRIDGEWATER, NJ 08807 | $298K |
| BENESYS INC EIN 38-3507129 PLAN ADMINISTRATOR | Claims processing; Direct payment from the plan; Contract Administrator; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | $127K |
| THE UNION LABOR LIFE INSURANCE CO EIN 13-1423090 NONE | Direct payment from the plan; Insurance services Service code 23 | ONE STREET NORTHWEST WASHINGTON, DC 20001 | $116K |
| HEALTH ALLIANCE PLAN OF MICHIGAN EIN 38-2242827 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 2850 W. GRAND BLVD DETROIT, MI 48202 | $101K |
| DIGITAL DATA, INC. EIN 04-3668352 NONE | Copying and duplicating Service code 36 | 5813 ROBERT STREET SHELBY TOWNSHIP, MI 48316 | $39K |
| ZELIS EIN 46-3708039 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $39K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Insurance services Service code 23 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $32K |
| AMERICAN GRAPHICS EIN 38-2090931 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 34895 GROSEBECK HIGHWAY CLINTON TOWNSHIP, MI 48035 | $21K |
| ASHER KELLY EIN 84-3379113 NONE | Legal; Direct payment from the plan Service code 29 | 25800 NORTHWESTERN HIGHWAY SOUTHFIELD, MI 48075 | $21K |
| EXPRESS SCRIPTS EIN 43-1420563 BENEFIT ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | 1 EXPRESSWAY ST LOUIS, MO 63121 | $20K |
| WALTER, BOESKY & ASSOCIATES P.C. EIN 38-3629743 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 17320 W. 12 MILE ROAD STE 200 SOUTHFIELD, MI 480762105 | $10K |
| DAVIS VISION INC EIN 11-3051991 NONE | Insurance services; Direct payment from the plan Service code 23 | 711 TROY-SCHENECTADY ROAD LATHAM, NY 12110 | $9K |
| AMERICARE MEDICAL INC. EIN 38-2364792 NONE | Other services; Direct payment from the plan Service code 49 | 1938 WOODSLEE DRIVE TROY, MI 48083 | $9K |
| MAGELLAN RX MANAGEMENT EIN 86-1042036 PHARMACY BENEFIT MANAGEME | Direct payment from the plan; Claims processing; Other fees Service code 12 | PO BOX 783053 PHILADELPHIA, PA 19178 | $9K |
| STROM ACTUARIAL SERVICES, L.L. ACTUARY | Direct payment from the plan; Actuarial Service code 11 | 31313 NORTHWESTERN HWY, SUITE 114 FRAMINGTON HILLS, MI 48334 | $9K |
| GOLDEN DENTAL PLANS INC EIN 38-2724203 NONE | Insurance services; Direct payment from the plan Service code 23 | 29377 HOOVER ROAD WARREN, MI 48093 | $8K |
| NICKEL & SAPH, INC EIN 38-1799688 NONE | Insurance services; Direct payment from the plan Service code 23 | 44 MACOMB PLACE MOUNT CLEMENS, MI 480436907 | $8K |
| WORK LIFE STRATEGIES EIN 80-0178558 NONE | Direct payment from the plan; Consulting (pension) Service code 17 | PO BOX 670444 DALLAS, TX 75367 | $7K |
| HEALTH DESIGN ENTERPRISES LLC EIN 38-3607439 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 1550 E BELTLINE SE GRAND RAPIDS, MI 49506 | $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 | 1,181 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 1,351 | $3.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 1,978 | $572K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 170 | $38K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 894 | $298K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 229 | $100K |
| Other | HAP PREFERRED INC | 1,000 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,978 | — |
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.