| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT J DOTSON JR3 Filed as: ROBERT J.JR DOTSON | PO BOX 1928 SAGINAW, MI 48605 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $25K | — | $25K | 1.84% |
| TRAVIS PORTA3 | 7219 GRAND RIVER ROAD BRIGHTON, MI 48114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 0.52% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.17% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD-STE 400 SOUTHFIELD, MI 480768076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $370 | — | $370 | 0.03% |
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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 398 | $1.4M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 398 | $1.4M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 398 | $1.4M |
| Other | NEW DIRECTIONS BEHAVIORAL HEALTH | 225 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.