| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | — | $12K | 3.49% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF MICHIGAN | 600 E. LAFAYETTE BLVD. SUITE 210 DETROIT, MI 48226 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.49% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 4.66% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 480841173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.00% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | VISION SERVICE PLAN | $992 | — | $992 | 5.91% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 480841173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $131 | — | $131 | 4.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 ADMINISTRATIVE SERVICE | Other fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Insurance services; Claims processing; Direct payment from the plan Service code 12 | 600 E. LAFAYETTE DETROIT, MI 48226 | $105K |
| WILSON PARTNERS II, LLC EIN 74-3127886 3 | Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions; Insurance agents and brokers; Other fees Service code 22 | 2250 BUTTERFIELD DR. SUITE 210 TROY, MI 48084 | $12K |
| BENEFIT ADMIN SERVICES INTERANTIONA EIN 38-2883561 HRA/FSA ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Contract Administrator Service code 12 | 9246 PORTAGE INDUSTRIAL DR. PORTAGE, MI 49024 | $7K |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 128 | $357K |
| Dental | DELTA DENTAL OF MICHIGAN | 229 | $83K |
| Vision | VISION SERVICE PLAN | 101 | $17K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 174 | $54K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 66 | $22K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 61 | $21K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 174 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.