| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LSG INSURANCE PARTNERS5 Filed as: LSG INSURANCE PARTNERS, INC. | 2600 S. TELEGRAPH RD. SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $3K | $24K | 10.06% |
| LSG INSURANCE PARTNERS5 Filed as: LSG INSURANCE PARTNERS, INC. | 2600 S. TELEGRAPH RD. SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $2K | $27K | 16.12% |
| GARY S. ROSENBERG3 | PO BOX 252555 WEST BLOOMFIELD, MI 48325 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $173 | $0 | $173 | 2.83% |
| PARAGON UNDERWRITERS3 | PO BOX 252555 WEST BLOOMFIELD, MI 48325 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $0 | $115 | 1.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other commissions; Consulting (general); Non-monetary compensation; Insurance agents and brokers; Insurance services; Direct payment from the plan; Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 600 LAFAYETTE BLVD. DETROIT, MI 48226 | $717K |
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 | 1,137 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,091 | $240K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,091 | $247K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,091 | $408K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,091 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.