| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES F PICKFORD | PO BOX 189 JACKSON, MI 49204 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $36K | $56 | $37K | 3.64% |
| JFP BENEFIT MANAGEMENT INC3 Filed as: JFP BENEFIT MANAGEMENT INC. | 100 S JACKSON ST., STE 200 JACKSON, MI 49201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 14.37% |
| JFP BENEFIT MANAGEMENT INC3 | 100 S JACKSON ST, STE 200 JACKSON, MI 49201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| JFP BENEFIT MANAGEMENT INC3 Filed as: JFP BENEFIT MANAGEMENT INC. | 100 S JACKSON ST, STE 200 JACKSON, MI 49201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JAMES F. PICKFORD EIN 38-2069753 | Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions Service code 22 | PO BOX 189 JACKSON, MI 49204 | $37K |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 262 | $1.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 262 | $1.0M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 262 | $1.0M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $58K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 262 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.