| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT J DOTSON JR3 | PO BOX 1928 SAGINAW, MI 486051928 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | $22K | $31K | 12.93% |
| EARL JEFFREY SAMS3 | PO BOX 1748 SAGINAW, MI 486051748 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 1.87% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.95% |
| SAGINAW UNDERWRITERS INC3 | PO BOX 1928 SAGINAW, MI 48605 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.02% |
| SAGINAW UNDERWRITERS INC3 Filed as: SAGINAW UNDERWRITERS, INC. | PO BOX 1928 SAGINAW, MI 48605 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Direct payment from the plan; Consulting (general); Insurance services; Float revenue; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $148K |
| ROBERT J DOTSON JR AGENT | Insurance agents and brokers; Other fees; Non-monetary compensation; Other commissions; Insurance brokerage commissions and fees Service code 22 | PO BOX 1928 SAGINAW, MI 48605 | $31K |
| SAGINAW BAY UNDERWRITERS BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other fees; Non-monetary compensation; Other commissions Service code 22 | 1258 S WASHINGTON SAGINAW, MI 486012509 | $8K |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 441 | $237K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $31K |
| Other(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 172 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.