| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT HUGHES3 | ADVANTAGE BENEFITS GRP INC 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 4.74% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GRP INC | 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 15.13% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GRP INC | 1 IONIA AVE SW SUITE 300 GRAND RAPIDS, MI 49503 | EYEMED VISION CARE- FIDELITY SECURITY LIFE INS CO | $151 | — | $151 | 10.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MULTI-PLAN INC EIN 13-3068979 NETWORK RENT-BILL AUDIT | Other services; Accounting (including auditing) Service code 10 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $67K |
| COMPASS BENEFITS GROUP EIN 37-1700328 INSURANCE BROKER | Insurance agents and brokers; Insurance services; Other services Service code 22 | 10327 GRAND RIVER DRIVE SUITE 406 BRIGHTON, MI 48116 | $47K |
| CONSOCIATE HEALTH EIN 37-1351918 TPA | Contract Administrator; Claims processing; Plan Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 2828 N MONROE STREET DECATUR, IL 62526 | $43K |
| TRUE RX HEALTH STRATEGISTS EIN 26-0502364 PBM | Direct payment from the plan; Claims processing; Contract Administrator; Plan Administrator Service code 12 | 2495 E NATIONAL HWY WASHINGTON, IN 47501 | $40K |
| 6 DEGREES HEALTH EIN 81-4242649 REPRICER/ COST CONTAINER | Other services Service code 49 | 3439 NE SANDY BLVD SUITE 384 PORTLAND, OR 97232 | $28K |
| 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 | $28K |
| AIMM - AULT INTL.MEDICAL MGMT. EIN 13-4254735 U/R & PRECERT | Other services; Consulting (general) Service code 16 | 1491 POLARIS PARKWAY BOX 213 COLUMBUS, OH 43240 | $15K |
| MEMD - TELE MED FEES EIN 46-3279589 SVC. PROVIDER | Direct payment from the plan; Other services Service code 49 | 6910 E.CHAUNCEY LANE SUITE 220 PHOENIX, AZ 85054 | $4K |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 211 | $65K |
| Vision | EYEMED VISION CARE- FIDELITY SECURITY LIFE INS CO | 196 | $1K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 149 | $50K |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE COMPANY | 132 | $225K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 259 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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.