| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT B LEE3 Filed as: SCOTT D FRITZ | 250 S EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $34K | — | $34K | 2.02% |
| TYRONE M JORDAN3 | 1605 CONCENTRIC BLVD SUITE 2 SAGINAW, MI 48604 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | — | $12K | 0.69% |
| NATIONAL INS. SERVICES OF WI,INC.3 Filed as: NATIONAL INS SERVICES OF WI | 300 N CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.06% |
| SCOTT B LEE3 Filed as: SCOTT D FRITZ | 250 S EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | BLUE CARE NETWORK OF MICHIGAN | $8K | — | $8K | 1.96% |
| TYRONE M JORDAN3 | 1605 CONCENTRIC BLVD SUITE 2 SAGINAW, MI 48604 | BLUE CARE NETWORK OF MICHIGAN | $3K | — | $3K | 0.72% |
| NATIONAL INS. SERVICES OF WI,INC.3 Filed as: NATIONAL INS SERVICES OF WI | 300 N CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | BLUE CARE NETWORK OF MICHIGAN | — | $219 | $219 | 0.05% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INSURERS GROUP INC | 13800 JACKSON ROAD MISHAWAKA, IN 46544 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $9K | $17K | 11.31% |
| NATIONAL INS. SERVICES OF WI,INC.3 Filed as: NATIONAL INS SERVICES OF WI | 300 N CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $1K | $9K | 5.87% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS SERVICES INC | 5250 CORPORATE DRIVE SUITE 200 TROY, MI 48098 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $51 | $3K | 1.95% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS SERVICES INC | 300 N BEACH STREET DAYTONA BEACH, FL 32114 | METROPOLITAN LIFE INSURANCE COMPANY | — | $522 | $522 | 0.35% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN LONE STAR INS SERVICE | 5850 GRANITE PARKWAY SUITE 350 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | — | $36 | $36 | 0.02% |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 273 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $147K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 273 | $2.1M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $147K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $147K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $147K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 273 | $2.1M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 356 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 356 | — |
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.