| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA L CLINE3 | 151 E MICHIGAN AVE KALAMAZOO, MI 490073907 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $25K | — | $25K | 3.04% |
| KEYSER INSURANCE GROUP3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.13% |
| PATRICIA L CLINE3 | 151 E MICHIGAN AVE KALAMAZOO, MI 490073907 | BLUE CARE NETWORK OF MICHIGAN | $21K | — | $21K | 3.06% |
| KEYSER INSURANCE GROUP3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | BLUE CARE NETWORK OF MICHIGAN | — | $953 | $953 | 0.14% |
| CHRISTOPHER T FISHER LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.01% |
| CHRISTOPHER T FISHER LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $493 | $2K | 14.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PROFESSIONAL BENEFITS SVCS EIN 38-3036973 TPA | Contract Administrator; Claims processing; Custodial (other than securities); Other services Service code 12 | 5300 PATTERSON AVE SE 150 GRAND RAPIDS, MI 49512 | $15K |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 194 | $1.5M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 186 | $11K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 194 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.