| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD, SUITE 200 TROY, MI 48084 | SUN LIFE ASSURANCE COMPANY OF CANADA | $25K | $7K | $32K | 6.47% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | DELTA DENTAL OF MICHIGAN | $8K | $459 | $9K | 3.17% |
| MARSH & MCLENNAN AGENCY LLC | 3331 W. BIG BEAVER RD, SUITE 200 TROY, MI 480842814 | RELIASTAR LIFE INSURANCE | $32K | — | $32K | 13.47% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD, SUITE 200 TROY, MI 48084 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $56 | $1K | 1.55% |
| WEYCO INC3 Filed as: WEYCO | 2370 SCIENCE PKWY OKEMOS, MI 48864 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.48% |
| ROBIN K SHELLENBERGER3 | 174 HICKORY HILLS MARSHALL, MI 49068 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $861 | — | $861 | 1.21% |
| DANIEL OWEN MACLELLAN3 | P.O. BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.17% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.10% |
| MERITAIN HEALTH3 Filed as: MERITAIN HEALTH INC | 300 CORPORATE PKWY AMHERST, NY 14226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.06% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD, SUITE 200 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $40K | $2K | $43K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Direct payment from the plan; Non-monetary compensation; Insurance brokerage commissions and fees; Claims processing; Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Contract Administrator; Insurance services; Float revenue; Other commissions Service code 12 | 600 E LAFAYETTE BLVD DETROIT, MI 48226 | $304K |
| MERTAIN HEALTH EIN 16-1264154 TPA | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 300 CORPORATE PKWY AMHERST, NY 14226 | $18K |
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 | 299 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 162 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 388 | $71K |
| Dental | DELTA DENTAL OF MICHIGAN | 694 | $280K |
| Vision | VISION SERVICE PLAN | 468 | $37K |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE | 473 | $306K |
| Short-term disability(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE | 473 | $306K |
| Long-term disability | RELIASTAR LIFE INSURANCE | 473 | $236K |
| Prescription drug | RXBENEFITS, INC. | 284 | $0 |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 390 | $497K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 694 | — |
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.