| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | — |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | — |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | — |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $19K | $0 | $19K | — |
| TOTAL BENEFIT SOLUTIONS3 Filed as: TOTAL CONTROL HEALTH PLANS | — | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE CO | $5K | $0 | $5K | — |
| COLDBROOK INSURANCE GROUP3 | — | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE CO | $494 | $0 | $494 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATOR | Claims processing; Direct payment from the plan; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Other fees; Contract Administrator Service code 12 | 600 E LAFAYETTE BLVD DETROIT, MI 48226 | $465K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 4100 OKEMOS RD. OKEMOS, MI 48864 | $28K |
| TOTAL CONTROL HEALTH PLANS EIN 82-4154183 AGENCY | Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions; Other fees Service code 22 | 148 S. RIVER AVE. SUITE 300 HOLLAND, MI 49423 | $28K |
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 | 926 | 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) | 926 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE CO | 1,114 | $0 |
| Life insurance(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,128 | $0 |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 404 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,128 | — |
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.