| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | $33K | — | $33K | 1.38% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | $1K | $12K | 1.59% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $3K | $21K | 7.67% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 2.99% |
| THE COLBURN CORPORATION3 | 3001 W. BIG BEAVER RD., SUITE 302 TROY, MI 48084 | VISION SERVICE PLAN | $708 | — | $708 | 2.33% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | VISION SERVICE PLAN | $708 | — | $708 | 2.33% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | HERITAGE VISION PLANS, INC. | $2K | — | $2K | 7.02% |
| J.S. CLARK AGENCY, INC.3 | 25900 WEST 11 MILE RD., SUITE 210 SOUTHFIELD, MI 48034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 12.24% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DRIVE MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.48% |
| W F HILL AND ASSOCIATES INC3 | 600 WEST LAFAYETTE DETROIT, MI 48226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $21 | $39 | 0.21% |
| DIANNA LYNN ATCHISON3 | 15130 SNOWBERRY CT SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $1 | $30 | 0.16% |
| JASON RODERICK3 | 2130 28TH STREET SW WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.15% |
No Schedule C service providers reported on this filing.
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 | 240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 155 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 531 | $3.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 554 | $202K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 519 | $59K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $279K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $279K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $279K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 531 | $3.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.