| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N ROSE STREET KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.61% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N ROSE STREET KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 10.88% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N ROSE STREET KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 12.77% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 27.05% |
| INCOME REPLACEMENT AGENCY3 | 34119 W 12 MILE RD STE 330 FARMINGTON HILLS, MI 48331 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 16.95% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $78 | $2K | 10.83% |
| AGIS NETWORK INC3 | 2122 KRATKY RD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $148 | $2K | 9.29% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 N ROSE STREET KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $317 | — | $317 | 19.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NGS AMERICAN, DBA NGS CORESOURCE EIN 38-2259531 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $276K |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 148 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 8 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 337 | $111K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 184 | $77K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL INSURANCE COMPANY | 363 | $561K |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 337 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.