| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY J HALL3 Filed as: AMY HALL | JS CLARK AGENCY 25900 W 11 MILE RD, STE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | $25K | — | $25K | 2.57% |
| J.S. CLARK AGENCY, INC.3 Filed as: J S CLARK AGENCY DBA OF ASSUR | 25900 W 11 MILE RD, STE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | — | $950 | $950 | 0.10% |
| AMY J HALL3 | 25900 W 11 MILE RD, STE 210 SOUTHFIELD, MI 48034 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 2.21% |
| J.S. CLARK AGENCY, INC.3 Filed as: J S CLARK AGENCY DBA OF ASSUR | 25900 W 11 MILE RD, STE 210 SOUTHFIELD, MI 480348034 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | — | $172 | $172 | 0.05% |
| J.S. CLARK AGENCY, INC.3 Filed as: J S CLARK AGENCY INC | 25900 W ELEVEN MILE RD, STE 210 SOUTHFIELD, MI 48034 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $6K | $29K | 13.70% |
| J.S. CLARK AGENCY, INC.3 Filed as: J S CLARK AGENCY | 25900 W ELEVEN MILE RD SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.17% |
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 | 141 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 251 | $1.3M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 231 | $211K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 244 | $15K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 231 | $211K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 251 | $1.3M |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 231 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.