| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | P.O. BOX 6392 GRAND RAPIDS, MI 495166392 | COMPANION LIFE | $94K | — | $94K | 18.00% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 48098 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $2K | $30K | 9.73% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 48098 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $835 | $18K | 14.40% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 480982609 | VISION SERVICE PLAN INSURANCE COMPANY | — | — | $0 | 0.00% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 48098 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 24.30% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 46.33% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 48098 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.98% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $275 | $5K | 53.84% |
| CREATIVE BENEFITS, INC.3 Filed as: CREATIVE BENEFIT SOLUTIONS, LLC | 5435 CORPORATE DRIVE SUITE 260 TROY, MI 48098 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $895 | — | $895 | 9.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | P.O. BOX 6392 GRAND RAPIDS, MI 495166392 | $256K |
| 4-D PHARMACY MANAGAMENT SYSTEMS, IN EIN 38-2828392 VENDOR | Claims processing Service code 12 | 2520 INDUSTRIAL ROW DRIVE TROY, MI 48084 | $51K |
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 | 432 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 432 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE | 432 | $524K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 426 | $28K |
| Vision | VISION SERVICE PLAN INSURANCE COMPANY | 431 | $71K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 459 | $467K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 459 | $356K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 459 | $335K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE | 432 | $524K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 195 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.