| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELISSA ARMATIS3 | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $25K | — | $25K | 1.52% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI, LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.13% |
| MELISSA ARMATIS3 | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | BLUE CARE NETWORK OF MICHIGAN | $24K | — | $24K | 1.92% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | BLUE CARE NETWORK OF MICHIGAN | $0 | $3K | $3K | 0.27% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | TOTAL HEALTH CARE USA, INC. | $11K | — | $11K | 4.01% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 3099 BIDDLE AVE WYADOTTE, MI 48192 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 18.37% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21031 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 8.99% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $327 | $327 | 0.14% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $206 | $206 | 0.09% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $35 | $35 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPSYCH EIN 35-3739783 TPA FEES | Contract Administrator; Claims processing Service code 12 | — | $0 |
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 | 1,165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 64 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,238 | 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 | 829 | $2.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 829 | $1.7M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 829 | $1.9M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,165 | $227K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,165 | $227K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,165 | $227K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 829 | $3.2M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,165 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,165 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.