| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RUTH3 | 7276 SNOW APPLE DR CLARKSTON, MI 48346 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $43K | $6K | $49K | 0.98% |
| KIMBERLY ANN WIXSON3 | 3001 WEST BIG BEAVER, SUITE 320 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.04% |
| JANELLE M. RUTH3 Filed as: JANELLE M RUTH | 7276 SNOW APPLE DRIVE CLARKSTON, MI 48346 | HUMANA INSURANCE COMPANY | $15K | — | $15K | 1.69% |
| MACQUEEN & ASSOCIATES LLC3 | 2191 12 MILE ROAD BERKLEY, MI 480721825 | THE UNION LABOR LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC EIN 38-2383171 NONE | Contract Administrator; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Copying and duplicating Service code 13 | — | $217K |
| SACHS WALDMAN PROFESSIONAL CORP EIN 38-1905521 SEE ATTACHED | Legal; Direct payment from the plan Service code 29 | — | $23K |
| ENVISION PHARMACETICAL SERVICES EIN 05-0570786 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $22K |
| BENDA, GRACE, STULZ & COMPANY PC EIN 38-2284921 SEE ATTACHED | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $14K |
| WELLS FARGO ADVISORS, LLC EIN 34-1542819 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $13K |
| THE SEGAL COMPANY, INC EIN 13-1975125 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $9K |
| AMERICAN GRAPHICS PRINTING NONE | Direct payment from the plan; Participant communication; Copying and duplicating Service code 36 | 34895 GROSBECK HIGHWAY CLINTON TOWNSHIP, MI 48035 | $8K |
| ULLIANCE, INC. NONE | Other services; Direct payment from the plan Service code 49 | 900 TOWER DRIVE SUITE 600 TROY, MI 48098 | $7K |
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 | 375 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 232 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 607 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 923 | $5.8M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 520 | $83K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 520 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 923 | — |
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.