| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEADOW INSURANCE GROUP3 | 26255 AMERICAN DRIVE SOUTHFIELD, MI 48034 | TOTAL HEALTH CARE USA INC | $37K | — | $37K | 1.65% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | TOTAL HEALTH CARE USA INC | $23K | — | $23K | 1.04% |
| MEADOWBROOK INC3 | 26255 AMERICAN DR SOUTHFIELD, MI 480346112 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 4.42% |
| DALY-MERRITT, INC.3 Filed as: DALY MERRITT INC | 3099 BIDDLE AVE WYANDOTTE, MI 481925901 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 1.28% |
| MEADOWBROOK INC3 | 26255 AMERICAN DR SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 4.81% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 2.25% |
| MEADOWBROOK INC3 | 26255 AMERICAN DR SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 4.99% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 2.24% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVENUE WYANDOTTE, MI 481925928 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $246 | — | $246 | 0.34% |
| JEANNETTE S STAPLETON3 | 34706 CENTAUR CLINTON TOWNSHIP, MI 48035 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 7.79% |
| MEADOWBROOK INC3 Filed as: MEADOWBROOK INSURANCE GROUP | 26255 AMERICAN DR SOUTHFIELD, MI 48034 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 6.65% |
| GREG A GOULD3 | 8150 GINGKO WAY DEXTER, MI 48130 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.58% |
| ANDREW J LOEWEN3 | 321 W HOBART AVE FINDLAY, OH 45840 | CONTINENTAL AMERICAN INSURANCE COMPANY | $615 | — | $615 | 1.22% |
| ALAN BERGMANN3 Filed as: ALAN W BERGMANN | 2144 MADERO DR THE VILLAGES, FL 32159 | CONTINENTAL AMERICAN INSURANCE COMPANY | $587 | — | $587 | 1.16% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | CONTINENTAL AMERICAN INSURANCE COMPANY | $471 | — | $471 | 0.93% |
| KRAIG M SEXTON3 | 9864 E GRAND RIVER SUITE 110 #292 BRIGHTON, MI 48116 | CONTINENTAL AMERICAN INSURANCE COMPANY | $463 | — | $463 | 0.92% |
| THOMAS W RINGWALD3 | 37231 N 110TH STREET SCOTTSDALE, AZ 85262 | CONTINENTAL AMERICAN INSURANCE COMPANY | $145 | — | $145 | 0.29% |
| NEGYLE A BEAMAN3 | 14313 CROSLEY REDFORD, MI 48239 | CONTINENTAL AMERICAN INSURANCE COMPANY | $142 | — | $142 | 0.28% |
| JIM M BULLOCK3 | 3715 POWDERHORN DR OKEMOS, MI 48864 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | — | $46 | 0.09% |
| AG AND ASSOCIATES3 | 2150 ASSOCIATION DRIVE SUITE 150 OKEMOS, MI 48863 | CONTINENTAL AMERICAN INSURANCE COMPANY | $38 | — | $38 | 0.08% |
| STEPHANIE L KESSELRING3 | 4112 W OAKELLAR AVE TAMPA, FL 33611 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| HEATHER A DOLLIVER3 | 212 W SILVER LK ROAD FENTON, MI 48430 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| HEIDI E GLAUB3 | 5458 PARKSIDE DRIVE BRIGHTON, MI 48114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| JEFFREY C WERNER3 Filed as: JEFFREY WERNER | 18096 TRUDY RD SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| CHRIS D BOULDREY3 | 340 WOOD HILLS DRIVE CONCORD, MI 49237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JULIE SLAUGHTER3 | 430 BOARDWALK WALLED LAKE, MI 48390 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JAMES C SNIDER JR3 Filed as: JAMES C SNIDER | 830 JUANITA RAEL WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MEADOWBROOK INC3 Filed as: MEADOWBROOK INSURANCE GROUP | 26255 AMERICAN DRIVE SOUTHFIELD, MI 480346112 | EYEMED VISION CARE | $3K | — | $3K | 9.96% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | EYEMED VISION CARE | $628 | — | $628 | 1.85% |
| MEADOWBROOK INC3 Filed as: MEADOWBROOK INSURANCE COMPANY | 26255 AMERICAN DRIVE SOUTHFIELD, MI 48034 | ZURICH AMERICAN INSURANCE COMPANY | $482 | — | $482 | 7.08% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | ZURICH AMERICAN INSURANCE COMPANY | $199 | — | $199 | 2.92% |
| GROUP BENEFIT OPTIONS3 | 2 CORPORATE DR. STE 636 SHELTON, CT 06484 | ZURICH AMERICAN INSURANCE COMPANY | $159 | — | $159 | 2.34% |
| RONALD CHAMBERS4 | 3281 PLATEAU PL CINCINNATI, OH 45241 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $844 | — | $844 | 19.00% |
| TONYA DEAN PETRILL4 | 1613 LOOKOUT CIR WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $113 | — | $113 | 2.54% |
| BRIAN GRAEF4 Filed as: BRIAN A GRAEF | 659 WOODCREEK CT SALINE, MI 48176 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $69 | — | $69 | 1.55% |
| ASSUREDPARTNERS4 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $43 | — | $43 | 0.97% |
| MARY JO NEVILLE4 | 29627 SPOON AVE MADISON HEIGHTS, MI 48071 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31 | — | $31 | 0.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TOTAL ADMINISTRATIVE SERVICES CORP. EIN 39-1561025 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $2K |
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 | 442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 455 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TOTAL HEALTH CARE USA INC | 442 | $2.3M |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 362 | $195K |
| Vision | EYEMED VISION CARE | 318 | $34K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $339K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $339K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $339K |
| Prescription drug | TOTAL HEALTH CARE USA INC | 442 | $2.3M |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 406 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 442 | — |
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.