| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICA L CLINE3 | 444 W MICHIGAN AVE KALAMAZOO, MI 490073907 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $31K | — | $31K | 3.49% |
| ROXANNA DIETERLE3 Filed as: ROXANNA DIETERIE | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 0.89% |
| CASSIE GOODBAND3 | 444 W MICHIGAN AVE KALAMAZOO, MI 490079007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 0.84% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 495039503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.29% |
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 | 226 | 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) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 226 | $884K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 226 | $884K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 226 | $884K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.