| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | $67K | $81K | $147K | 5.28% |
| BRIAN W PATTEN3 Filed as: BRIAN PATTEN AND ASSOCIATES LLC | 120 MARGUERITE DRIVE SUITE 101 CRANBERRY TWP, PA 16066 | HARTFORD LIFE AND ACCIDENT | $27K | $1K | $28K | 1.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLAN INC | $64K | $3 | $64K | 4.94% |
| COWDEN ASSOCIATES INC3 | 444 LIBERTY AVENUE STE 1900 PITTSBURGH, PA 15222 | BLUE CROSS & BLUE SHIELD OF MICHIGAN | — | $84K | $84K | 7.70% |
| ELLIOT N DINKIN3 | 444 LIBERTY AVENUE SUITE 605 PITTSBURGH, PA 15222 | BLUE CROSS & BLUE SHIELD OF MICHIGAN | $38K | — | $38K | 3.50% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 5.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MUSGROVE ASSOCIATES NONE | Direct payment from the plan; Contract Administrator Service code 13 | P.O. BOX 1769 SALEM, VA 24153 | $2.2M |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other fees Service code 12 | — | $2.2M |
| 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 | $557K |
| COWDEN ASSOCIATES, INC. EIN 25-1750131 NONE | Insurance agents and brokers; Direct payment from the plan; Consulting (general) Service code 16 | — | $241K |
| BDO USA, P.C. EIN 13-5381590 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $201K |
| ANDREA GIBBS EIN 41-2499450 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $72K |
| GREGORY, MOORE JEAKLE & BROOKS PC EIN 38-3093929 NONE | Legal; Direct payment from the plan Service code 29 | — | $71K |
| VARNUM EIN 38-1294924 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $61K |
| GENERAL PLACEMENT SERVICES EIN 25-1722919 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $30K |
| BECKERMAN & COMPANY NONE | Direct payment from the plan; Insurance services Service code 23 | 430 LAKE AVE. COLONIA, NJ 07067 | $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 | 4,843 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,847 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,738 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,117 | $2.8M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,117 | $2.8M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,117 | $2.8M |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,738 | $1.1M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS & BLUE SHIELD OF MICHIGAN | 5,738 | $1.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,117 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,738 | — |
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.