| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLDBROOK INSURANCE GROUP3 | 2000 OAK INDUSTRIAL DR STE B GRAND RAPIDS, MI 49505 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | — | $28K | 3.50% |
| COLDBROOK INSURANCE GROUP3 | 45 COLDBROOK ST NW GRAND RAPIDS, MI 49503 | DELTA DENTAL | $5K | $1K | $6K | 1.44% |
| COLDBROOK INSURANCE GROUP3 | 2000 OAK INDUSTRIAL DR STE B GRAND RAPIDS, MI 49505 | LIFE INSURANCE GROUP OF AMERICA | $5K | — | $5K | 4.09% |
| MICHIGAN CHAMBER SERVICES, INC.3 Filed as: MICHIGAN CHAMBER SERVICES INC | 600 S WALNUT ST LANSING, MI 489332209 | VISION SERVICE PLAN | $7K | — | $7K | 8.00% |
| COLDBROOK INSURANCE GROUP3 | 2000 OAK INDUSTRIAL DR STE B GRAND RAPIDS, MI 49505 | VISION SERVICE PLAN | $4K | — | $4K | 5.00% |
| COLDBROOK INSURANCE GROUP3 | 2000 OAK INDUSTRIAL DR STE B GRAND RAPIDS, MI 49505 | LIFE INSURANCE GROUP OF AMERICA | $5K | — | $5K | 6.90% |
| COLDBROOK INSURANCE GROUP3 | 2000 OAK INDUSTRIAL DR STE B GRAND RAPIDS, MI 49505 | LIFE INSURANCE GROUP OF AMERICA | $2K | — | $2K | 24.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Consulting (general); Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Insurance services; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 600 LAFAYETTE EAST DETRIOT, MI 48226 | $618K |
| COLDBROOK INSURANCE GROUP AGENT/BROCKER | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Other commissions Service code 22 | 45 COLDBROOK GRAND RAPIDS, MI 49505 | $28K |
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 | 966 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 976 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 1,690 | $412K |
| Vision | VISION SERVICE PLAN | 764 | $88K |
| Life insurance | LIFE INSURANCE GROUP OF AMERICA | 966 | $110K |
| Long-term disability | LIFE INSURANCE GROUP OF AMERICA | 966 | $76K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,691 | $794K |
| Other | LIFE INSURANCE GROUP OF AMERICA | 966 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,691 | — |
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."
No prospect flags tripped on this filing.