| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT INC | PO BOX 8029 STERLING HEIGHTS, MI 48311 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $47K | — | $47K | 5.80% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $215 | $215 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT INC | PO BOX 8029 STERLING HEIGHTS, MI 48311 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 1.40% |
| BROWN AND BROWN OF FLORIDA, INC.5 Filed as: BROWN & BROWN OF DETROIT INC | PO BOX 8029 STERLING HEIGHTS, MI 48311 | VISION SERVICE PROVIDER | $2K | $0 | $2K | 2.66% |
| BROWN AND BROWN OF FLORIDA, INC.4 Filed as: BROWN & BROWN OF DETROIT INC | PO BOX 8029 STERLING HEIGHTS, MI 48311 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $66K | $5K | $70K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MI EIN 38-2069753 TPA | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan; Contract Administrator; Float revenue; Other fees; Claims processing Service code 12 | — | $417K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other commissions Service code 22 | — | $70K |
| DELTA DENTAL EIN 38-1791480 TPA | Contract Administrator; Claims processing Service code 12 | — | $39K |
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 | 600 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 110 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 710 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 553 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 1,244 | $467K |
| Vision | VISION SERVICE PROVIDER | 451 | $94K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 600 | $813K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 600 | $813K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 553 | $0 |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 600 | $813K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,244 | — |
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.