| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLAIRE E. KLINGELHOFER3 | 638 DETROIT AVE. LAKE ORION, MI 48362 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $21K | $14K | $35K | 5.80% |
| NFP INSURANCE SERVICES INC3 Filed as: APEX BENEFIT MANAGEMENT LLC | 638 DETROIT AVE LAKE ORION, MI 48362 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $775 | $775 | 0.13% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 4.76% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | VISION SERVICE PLAN | $1K | — | $1K | 4.95% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $643 | — | $643 | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $218 | — | $218 | 5.00% |
| HERMAN H KLINGELHOFER3 | 638 DETROIT AVE. LAKE ORION, MI 48362 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $121 | — | $121 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Consulting (general); Insurance services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $117K |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 301 | $612K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 301 | $716K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 301 | $638K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 301 | $612K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.