| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT HUGHES3 | 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 4.77% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $1K | $8K | 15.79% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE- FIDELITY SECURITY LIFE INS CO | $183 | — | $183 | 10.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPASS BENEFITS GROUP EIN 37-1700328 INSURANCE BROKER | Insurance services; Insurance agents and brokers; Direct payment from the plan; Other services Service code 22 | 10327 GRAND RIVER DRIVE SUITE 406 BRIGHTON, MI 48116 | $52K |
| CONSOCIATE HEALTH EIN 37-1351918 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Claims processing; Plan Administrator Service code 12 | 2828 N MONROE STREET DECATUR, IL 62526 | $48K |
| SHARX , LLC EIN 84-3019478 SPECIALTY MED ADVISORS | Direct payment from the plan; Other services Service code 49 | 600 MASON RIDGE CENTER DR FLOOR 2 ST. LOUIS, MO 63141 | $42K |
| TRUE RX HEALTH STRATEGISTS EIN 26-0502364 PBM | Direct payment from the plan; Contract Administrator; Plan Administrator; Claims processing Service code 12 | 2495 E NATIONAL HWY WASHINGTON, IN 47501 | $40K |
| MUTI-PLAN EIN 13-3068979 NETWORK RENTAL/ BILL AUDI | Other services; Accounting (including auditing) Service code 10 | PO BOX 29380 NEW YORK, NY 10087 | $36K |
| 6 DEGREES HEALTH EIN 81-4242649 REPRICER/ COST CONTAINER | Other services Service code 49 | 5800 NE PINEFARM CT. SUITE 200 HILLSBORO, OR 97124 | $31K |
| AIMM - AULT INTL. MEDICAL MGMT. EIN 13-4254735 U/R & PRECERT | Consulting (general); Other services Service code 16 | 1491 POLARIS PARKWAY BOX 213 COLUMBUS, OH 43240 | $16K |
| MEMD - TELE MED FEES EIN 46-3279589 SVC. PROVIDER | Direct payment from the plan; Other services Service code 49 | 7332 E. BUTHERUS SCOTTSDALE, AZ 85260 | $5K |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 239 | $79K |
| Vision | EYEMED VISION CARE- FIDELITY SECURITY LIFE INS CO | 217 | $2K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 159 | $53K |
| Stop-loss / reinsurancereinsurance | PAN-AMERCIAN LIFE INSURANCE COMPANY | 153 | $246K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 159 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.