| 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 | $27K | $0 | $27K | 3.46% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 4.72% |
| 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 | 5.62% |
| WILSON PARTNERS II, LLC3 | 2250 BUTTERFIELD DRIVE SUITE 210 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $115 | $0 | $115 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| 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 | $123K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Other fees; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Contract Administrator; Claims processing Service code 12 | 600 E. LAFAYETTE BLVD. DETROIT, MI 48226 | $99K |
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 | 215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $786K |
| Dental | DELTA DENTAL OF MICHIGAN | 270 | $91K |
| Vision | VISION SERVICE PLAN | 115 | $19K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $53K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 77 | $26K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 59 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $786K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 265 | $786K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.