| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHARON SCHLENKER3 | 3025 HIGHLAND PARKWAY STE 650 DOWNERS GROVE, IL 605150515 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $29K | $0 | $29K | 1.01% |
| SCOTT M WHITE3 | 300 S FRONT ST MARQUETTE, MI 498559855 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $0 | $10K | 0.35% |
| DANIEL M WOLF3 Filed as: DANIEL THOMAS, JR | 300 S FRONT ST MARQUETTE, MI 49855 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | $0 | $12K | 1.08% |
| CITY INSURANCE AGENCY, INC.3 Filed as: CITY INSURANCE AGENCY INC | 300 SOUTH FRONT ST MARQUETTE, MI 49855 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $36K | $0 | $36K | 7.60% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES, LLC | 3025 HIGHLAND PARKWAY, STE 650 DOWNERS GROVE, IL 60515 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 2.92% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $63 | $63 | 0.01% |
| CITY INSURANCE AGENCY, INC.3 | 722 W WASHINGTON ST. MARQUETTE, MI 49855 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 3.65% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES, LLC | 1900 SPRING RD OAK BROOK, IL 60523 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 0.69% |
| NATIONAL BENEFIT CONSULTANTS, INC.3 | 208 E OAK CREST DRIVE WALES, WI 53183 | UNITED AMERICAN INSURANCE COMPANY | $14K | $0 | $14K | 10.00% |
| NATIONAL BENEFITS CONSULTANTS, INC.3 | 208 E OAK CREST DRIVE WALES, WI 53183 | EXPRESS SCRIPTS, INC | $3K | $0 | $3K | 2.04% |
| CITY INSURANCE AGENCY, INC.3 | 300 FRONT STREET MARQUETTE, MI 49855 | EYEMED VISION CARE | $1K | — | $1K | 5.66% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY, SUITE 650 DOWNERS GROVE, IL 60515 | EYEMED VISION CARE | $589 | — | $589 | 2.33% |
| CITY INSURANCE AGENCY, INC.3 | 300 S. FRONT STREET MARQUETTE, MI 49855 | EYEMED VISION CARE | $171 | — | $171 | 3.15% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY, SUITE 650 DOWNERS GROVE, IL 60515 | EYEMED VISION CARE | $70 | — | $70 | 1.29% |
| CITY INSURANCE AGENCY, INC.3 | 300 S. FRONT STREET MARQUETTE, MI 49855 | EYEMED VISION CARE | $384 | — | $384 | 13.34% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY, SUITE 650 DOWNERS GROVE, IL 60515 | EYEMED VISION CARE | $158 | — | $158 | 5.49% |
| CITY INSURANCE AGENCY, INC.3 Filed as: CITY INSURANCE AGENCY | 300 S. FRONT STREET MARQUETTE, MI 49855 | EYEMED VISION CARE | $149 | — | $149 | 7.13% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY, SUITE 650 DOWNERS GROVE, IL 60515 | EYEMED VISION CARE | $62 | — | $62 | 2.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STATE STREET BANK AND TRUST EIN 04-1867445 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $36K |
| TOWERS WATSON INVESTMENT SVC INC EIN 52-1868818 NONE | Investment management fees paid directly by plan; Securities brokerage; Investment management; Direct payment from the plan Service code 28 | — | $33K |
| SCHENCK SC EIN 39-1173131 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $9K |
| TOWERS WATSON DELAWARE INC. EIN 53-0181291 NONE | Securities brokerage; Investment management fees paid directly by plan; Investment management Service code 28 | — | $6K |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 302 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 483 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 581 | $4.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 572 | $215K |
| Vision(4 contracts) | EYEMED VISION CARE | 340 | $36K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 384 | $468K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 384 | $468K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 384 | $468K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 581 | $4.1M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 384 | $473K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 581 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.