| 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 | $8K | $27K | $35K | 14.62% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $7K | $7K | 2.82% |
| SAGINAW BAY UNDERWRITERS3 Filed as: SAGINAW UNDERWRITERS INC | PO BOX 1928 SAGINAW, MI 48605 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.67% |
| SAGINAW BAY UNDERWRITERS3 Filed as: SAGINAW UNDERWRITERS INC | PO BOX 1928 SAGINAW, MI 48605 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| SAGINAW BAY UNDERWRITERS3 Filed as: SAGINAW UNDERWRITERS, INC. | PO BOX 1928 SAGINAW, MI 48605 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Insurance services; Claims processing; Other fees; Float revenue; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $152K |
| ROBERT J DOTSON JR AGENT | Other commissions; Insurance agents and brokers; Other fees; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | PO BOX 1928 SAGINAW, MI 48605 | $35K |
| SAGINAW BAY UNDERWRITERS BROKER | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other commissions; Other fees Service code 22 | 1258 S WASHINGTON SAGINAW, MI 486012509 | $19K |
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 | 179 | 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) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 422 | $239K |
| Life insurance(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 181 | $75K |
| Other(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 181 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.