| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRYSTN CLARK3 | 35735 MOUND ROAD STERLING HEIGHTS, MI 48310 | BLUE CARE NETWORK OF MICHIGAN | $23K | $0 | $23K | 2.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | BLUE CARE NETWORK OF MICHIGAN | $0 | $753 | $753 | 0.10% |
| KRYSTN CLARK3 | 35735 MOUND ROAD STERLING HEIGHTS, MI 48310 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | $0 | $26K | 3.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $560 | $560 | 0.07% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF DETROIT, INC. | 35735 MOUND ROAD STERLING HEIGHTS, MI 48310 | STANDARD INSURANCE COMPANY | $12K | $0 | $12K | 13.71% |
| KRYSTN CLARK3 | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | DELTA DENTAL OF MICHIGAN | $7K | $0 | $7K | 9.97% |
| TRACY KATZ LLC4 Filed as: TRACY KATZ, LLC | 1662 EAST MELTON ROAD BIRMINGHAM, MI 48009 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 19.56% |
| BROWN AND BROWN OF FLORIDA, INC.4 Filed as: BROWN AND BROWN OF DETROIT, INC. | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $715 | $0 | $715 | 13.08% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 194 | $1.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 213 | $73K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 194 | $761K |
| Life insurance | STANDARD INSURANCE COMPANY | 172 | $90K |
| Short-term disability | STANDARD INSURANCE COMPANY | 172 | $90K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 194 | $1.5M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 172 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.