| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W. 47TH ST. STE. 900A STOP LOSS DALLAS, TX 75217 | SUN LIFE ASSURANCE COMPANY OF CANADA | $420 | — | $420 | 4.57% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P. O. BOX 843844 KANSAS CITY, MO 64184 | SUN LIFE ASSURANCE COMPANY OF CANADA | $294 | — | $294 | 3.20% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 600 WOODWARD AVE. SUITE 1900 DETROIT, MI 48226 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $424 | $424 | 14.35% |
| ELAINE C. COFFMAN3 | 325 N. OLD WOODWARD AVE. SUITE 370 BIRMINGHAM, MI 48009 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $69 | — | $69 | 2.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue; Insurance services; Consulting (general) Service code 12 | — | $17K |
| AUTOMATED BENEFIT SERVICES INC. EIN 38-2598766 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 36 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 53 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 53 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.