| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA5 Filed as: BLUE CROSS BLUE SHIELD OF MICHIGAN | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $187K | $187K | 72.53% |
| ROBERT J DOTSON JR3 | PO BOX 1928 SAGINAW, MI 486051928 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $28K | $38K | 14.81% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 1.14% |
| ROBERT J DOTSON JR3 | PO BOX 1928 SAGINAW, MI 486051928 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 4.72% |
| ROBERT J DOTSON JR3 | PO BOX 1928 SAGINAW, MI 486051928 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 44.14% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 12.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Other fees; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Contract Administrator; Claims processing Service code 12 | — | $187K |
| ROBERT J DOTSON JR INSURANCE AGENT | Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Insurance agents and brokers Service code 22 | PO BOX 1928 SAGINAW, MI 486051928 | $54K |
| SAGINAW BAY UNDERWRITERS INSURANCE BROKER | Non-monetary compensation; Insurance agents and brokers; Other fees; Other commissions; Insurance brokerage commissions and fees Service code 22 | 1258 S WASHINGTON SAGINAW, MI 486012509 | $6K |
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 | 251 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 251 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 399 | $258K |
| Dental | DELTA DENTAL OF MICHIGAN | 361 | $123K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 342 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 399 | $258K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 399 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 399 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.