| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAIGE BENEFIT DESIGNS INC.3 | 44 W. CENTER ST SANFORD, MI 48657 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $30 | $3K | 8.56% |
| MARSH & MCLENNAN AGENCY LLC3 | 7015 COLLEGE BLVD, STE 400 OVERLAND PARK, KS 66211 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $317 | $30 | $347 | 0.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other fees; Other commissions; Direct payment from the plan; Float revenue; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $216K |
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 | 248 | 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) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 248 | $38K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 236 | $317K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 248 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.