| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIAN W PATTEN3 Filed as: BRIAN PATTEN AND ASSOCIATES LLC | 120 MARGUERITE DRIVE SUITE 101 CRANBERRY TWP, PA 16066 | HARTFORD LIFE AND ACCIDENT | $78K | $2K | $81K | 3.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | — | $59K | $59K | 2.76% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLAN INC | $83K | — | $83K | 5.82% |
| ELLIOT N DINKIN3 | 444 LIBERTY AVENUE SUITE 605 PITTSBURGH, PA 15222 | BLUE CROSS & BLUE SHIELD OF MICHIGAN | $38K | — | $38K | 3.50% |
| COWDEN ASSOCIATES INC3 | 444 LIBERTY AVENUE STE 1900 PITTSBURGH, PA 15222 | BLUE CROSS & BLUE SHIELD OF MICHIGAN | $0 | $28K | $28K | 2.63% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 5.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Insurance services; Consulting (general); Contract Administrator; Direct payment from the plan; Claims processing; Other fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $2.1M |
| MUSGROVE ASSOCIATES NONE | Direct payment from the plan; Contract Administrator Service code 13 | P.O. BOX 1769 SALEM, VA 24153 | $1.4M |
| BRIAN PATTEN & ASSCOCIATES LLC NONE | Insurance agents and brokers; Consulting (general); Direct payment from the plan Service code 16 | 120 MARGUERITE DRIVE SUITE 100 CRANBERRY TOWNSHIP, PA 16066 | $1.3M |
| BENESYS EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $561K |
| COWDEN ASSOCIATES, INC. EIN 25-1750131 NONE | Direct payment from the plan; Insurance agents and brokers; Consulting (general) Service code 16 | — | $265K |
| BDO USA, P.C. EIN 13-5381590 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $119K |
| GREGORY, MOORE JEAKLE & BROOKS PC EIN 38-3093929 NONE | Legal; Direct payment from the plan Service code 29 | — | $79K |
| BECKERMAN & COMPANY NONE | Direct payment from the plan; Insurance services Service code 23 | 430 LAKE AVE. COLONIA, NJ 07067 | $29K |
| AMERICAN GRAPHICS PRINTING CO. NONE | Other services; Direct payment from the plan Service code 49 | 34895 GROESBECK HWY. CLINTON TWP, MI 48035 | $8K |
| WESTERN INTERNATIONAL SECURITIES NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | 4510 E THOUSAND OAKS BLVD WEST LAKE VILLAGE, CA 91362 | $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 | 5,765 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,769 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,907 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,325 | $2.2M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,325 | $2.2M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,325 | $2.2M |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,907 | $1.1M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,907 | $1.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,325 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,907 | — |
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.