| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRYSTN CLARK3 | 35735 MOUND ROAD STERLING HEIGHTS, MI 48310 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $29K | $0 | $29K | 3.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $726 | $726 | 0.08% |
| KRYSTN CLARK3 | 35735 MOUND ROAD STERLING HEIGHTS, MI 48310 | BLUE CARE NETWORK OF MICHIGAN | $25K | $0 | $25K | 3.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | BLUE CARE NETWORK OF MICHIGAN | $0 | $888 | $888 | 0.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | STANDARD INSURANCE COMPANY | $18K | $2K | $21K | 17.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 5250 CORPORATE DRIVE, SUITE 200 TROY, MI 48098 | DELTA DENTAL OF MICHIGAN | $8K | $0 | $8K | 9.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | DELTA DENTAL OF MICHIGAN | $666 | $0 | $666 | 0.78% |
| TRACY KATZ LLC4 | 1662 EAST MELTON ROAD BIRMINGHAM, MI 48009 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $647 | $0 | $647 | 16.75% |
| BROWN AND BROWN OF FLORIDA, INC.4 Filed as: BROWN & BROWN INS. SERVICES, INC. | PO BOX 746567 ATLANTA, GA 30374 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $471 | $0 | $471 | 12.19% |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 208 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 228 | $85K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 208 | $942K |
| Life insurance | STANDARD INSURANCE COMPANY | 181 | $118K |
| Short-term disability | STANDARD INSURANCE COMPANY | 181 | $118K |
| Long-term disability | STANDARD INSURANCE COMPANY | 181 | $118K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 208 | $1.8M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 181 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.