| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A KELLEHER3 Filed as: ROBERT A. WILSON | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $23K | $0 | $23K | 3.40% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 4.37% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 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 | 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 | $1K | $0 | $1K | 5.64% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $128 | $0 | $128 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Float revenue; Other fees; Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services Service code 12 | 600 E. LAFAYETTE DETROIT, MI 48226 | $94K |
| WILSON PARTNERS II, LLC EIN 74-3127886 BROKER | Insurance agents and brokers; Other fees; Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions Service code 22 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | $23K |
| BENEFIT ADMIN SERVICES INT. CORP. EIN 38-2883561 TPA | Contract Administrator; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Claims processing Service code 12 | 9246 PORTAGE INDUSTRIAL DRIVE PORTAGE, MI 49024 | $8K |
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 | 216 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 263 | $680K |
| Dental | DELTA DENTAL OF MICHIGAN | 245 | $85K |
| Vision | VISION SERVICE PLAN | 108 | $19K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 216 | $51K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 71 | $25K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 60 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 263 | $680K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 263 | $680K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 216 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.