| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT J DOTSON JR3 | P.O. BOX 1928 SAGINAW, MI 486051928 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $23K | — | $23K | 3.36% |
| SAGINAW BAY UNDERWRITERS3 | 1258 SOUTH WASHINGTON AVENUE SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.26% |
| SAGINAW BAY UNDERWRITERS3 Filed as: SAGINAW UNDERWRITERS INC. | P.O. BOX 1748 SAGINAW, MI 48605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | — | $11K | 6.59% |
| SAGINAW BAY UNDERWRITERS3 | P.O. BOX 1928 SAGINAW, MI 48605 | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 3.85% |
| SAGINAW BAY UNDERWRITERS3 | P.O. BOX 1928 SAGINAW, MI 486051928 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
No Schedule C service providers reported on this filing.
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 214 | $782K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 151 | $12K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $161K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $161K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $161K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 214 | $782K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.