| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMERON M KENNEDY3 | 400 W FOURTH STREET STE 300 ROYAL OAK, MI 48067 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | $33K | $41K | 11.85% |
| ELAINE C. COFFMAN3 Filed as: ELAINE C COFFMAN | 325 N OLD WOODWARD AVE SUITE 370 BIRIMINGHAM, MI 48009 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $17K | $21K | 5.99% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH STREET STE 300 ROYAL OAK, MI 48067 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.59% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH STREET STE 300 ROYAL OAK, MI 48067 | PRUDENTIAL INSURANCE COMPANY | $12K | — | $12K | 5.45% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 1185 AVE. OF THE AMERICAS STE 2010 NEW YORK, NY 10036 | PRUDENTIAL INSURANCE COMPANY | $6K | — | $6K | 2.72% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY | — | $42 | $42 | 0.02% |
| CAMERON M KENNEDY3 | 400 W FOURTH STREET STE 300 ROYAL OAK, MI 48067 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 3.11% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES, LLC - ROBERT VOG | 444 W 47TH ST SUITE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 1.61% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH STREET STE 300 ROYAL OAK, MI 48067 | NGL | $2K | — | $2K | 5.73% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES | 444 W 47TH ST SUITE 900 KANSAS CITY, MO 64112 | NGL | $1K | — | $1K | 4.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Contract Administrator; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other fees; Direct payment from the plan Service code 12 | PO BOX 2888 DETROIT, MI 48231 | $168K |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 422 | $151K |
| Vision | NGL | 384 | $29K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY | 210 | $222K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY | 210 | $222K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY | 210 | $222K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 182 | $347K |
| Other | PRUDENTIAL INSURANCE COMPANY | 210 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.