| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATION BENEFITS CO3 Filed as: ASSOCIATION BENEFITS COMPANY | — | HUMANA | $21K | — | $21K | 2.96% |
| MICHAEL BUCK3 | 38223 MOUND ROAD BUILDING F STERLING HEIGHTS, MI 483103466 | BLUE CROSS BLUE SHIELD | $12K | — | $12K | 3.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 MEDICAL CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Claims processing; Direct payment from the plan; Float revenue; Other fees; Contract Administrator; Consulting (general) Service code 12 | — | $267K |
| BENESYS INC EIN 38-2383171 PLAN TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Accounting (including auditing); Other fees; Participant communication; Copying and duplicating Service code 10 | — | $79K |
| THE SALUS GROUP MEDICAL BENEFIT CONSULTAN | Insurance agents and brokers; Direct payment from the plan; Insurance services Service code 22 | 38221 MOUND ROAD STERLING HEIGHTS, MI 48310 | $48K |
| PNC BANK PLAN BANK | Other fees; Other services; Direct payment from the plan Service code 49 | ONE FINANCIAL PARKWAY KALAMAZOO, MI 49009 | $26K |
| LEDBETTER PARISI LLC EIN 03-0599899 PLAN LEGAL COUNCIL | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $24K |
| ELIXER EIN 05-0570786 PRECRIPTION CLAIMS PROCES | Direct payment from the plan; Claims processing Service code 12 | — | $11K |
| WRUBEL WESLEY AND COMPANY C.P.A.'S EIN 38-2574238 PLAN AUDITOR | Actuarial; Direct payment from the plan Service code 11 | — | $9K |
| HEALTH PLAN ADVOCATE NONE | Other services; Direct payment from the plan Service code 49 | 5380 CASCADE ROAD SE SUITE 200 GRAND RAPIDS, MI 49546 | $7K |
| ULLIANCE INC NONE | Other services; Direct payment from the plan Service code 49 | 900 TOWER DRIVE TROY, MI 48098 | $7K |
| AMERICAN HEALTH HOLDING NONE | Direct payment from the plan; Other services Service code 49 | P.O.BOX 360142 PITTSBURGH, PA 152506142 | $7K |
| CUNI RUST AND STRENK PLAN ACTUARY | Accounting (including auditing); Direct payment from the plan Service code 10 | 4555 LAKE FOREST DRIVE SUITE #620 CINCINNATI, OH 45242 | $6K |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 164 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA | 196 | $696K |
| Dental | HUMANA | 196 | $696K |
| Vision | HUMANA | 196 | $696K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD | 265 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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.