| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROXANNA DIETERLE3 | UNKNOWN BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $36K | $0 | $36K | 3.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $0 | $1K | $1K | 0.13% |
| ROXANNA DIETERLE3 | UNKNOWN BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $23K | $0 | $23K | 3.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $600 | $600 | 0.08% |
| ROXANNA DIETERLE3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $16K | $0 | $16K | 8.31% |
| ROXANNA DIETERLE3 | 300 OTTAWA AVENUE NW, SUITE 300 GRAND RAPIDS, MI 49503 | KANSAS CITY LIFE INSURANCE COMPANY | $13K | $0 | $13K | 10.12% |
No Schedule C service providers reported on this filing.
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 243 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 420 | $196K |
| Vision | VISION SERVICE PLAN | 146 | $38K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 199 | $124K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 199 | $124K |
| Long-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 199 | $124K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 243 | $1.8M |
| Other | KANSAS CITY LIFE INSURANCE COMPANY | 199 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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.