| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRAVIS PORTA3 | 7219 GRAND RIVER ROAD BRIGHTON, MI 48114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $34K | — | $34K | 1.97% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.13% |
| TRAVIS PORTA3 | 7219 GRAND RIVER BRIGHTON, MI 48114 | DELTA DENTAL OF MICHIGAN | $7K | $981 | $8K | 5.39% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS INC. | 7219 W GRAND RIVER BRIGHTON, MI 48114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS INC. | 7219 W. GRAND RIVER BRIGHTON, MI 48114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS INC. | 7219 W GRAND RIVER BRIGHTON, MI 48114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GRACE AND PORTA BENEFITS INC3 Filed as: GRACE & PORTA BENEFITS INC. | 7219 W GRAND RIVER BRIGHTON, MI 48114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
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 | 221 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 377 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 385 | $156K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 377 | $1.7M |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $73K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $82K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $30K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 377 | $1.7M |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 225 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 385 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.