| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 5.18% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CENTER ST NW SUITE 200 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 13.99% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 49503 | EYE MED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY | $228 | — | $228 | 9.18% |
| KURT B. SWARDENSKI3 Filed as: KURT B SWARDENSKI | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | $24K | $35K | — |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA/ STOP LOSS INS | Other fees; Insurance services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 12 | 600 LAFAYETTE EAST DETROIT, MI 48226 | $199K |
| KURT B SWARDENSKI AGENT/ BROKER | Other commissions; Insurance brokerage commissions and fees; Non-monetary compensation; Other fees; Insurance agents and brokers Service code 22 | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 495032662 | $35K |
| PHARMACEUTICAL TECHNOLOGIES INC. EIN 47-0764793 TPA | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Other fees; Claims processing Service code 12 | 13660 CALIFORNIA STREET OMAHA, NE 68154 | $8K |
| ADVANTAGE BENEFITS GROUP INC AGENT/ BROKER | Other commissions; Other fees; Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 89 MONROE CENTER NW STE. 200 GRAND RAPIDS, MI 49503 | $2K |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 211 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 386 | $103K |
| Vision | EYE MED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY | 347 | $2K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 264 | $56K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 211 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 211 | $0 |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 264 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.