| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS H ROEHM3 | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $32K | — | $32K | 2.72% |
| AFFILIATED AGENCIES LLC3 | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.13% |
| DOUGLAS H ROEHM3 Filed as: DOUGLAS ROEHM | AFFILIATED AGENCIES, LLC 5925 MERIDIAN BOULEVARD BRIGHTON, MI 48116 | DELTA DENTAL OF MICHIGAN | $5K | $501 | $6K | 5.38% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | SYMETRA LIFE INSURANCE COMPANY | $9K | $5K | $14K | 15.16% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE SUITE 200 ROCHESTER HILLS, MI 48307 | VISION SERVICE PLAN | $2K | — | $2K | 8.86% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 252 | $1.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 282 | $105K |
| Vision | VISION SERVICE PLAN | 128 | $19K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 182 | $90K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 182 | $90K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 182 | $90K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 252 | $1.2M |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 182 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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.