| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY M ROUSH HELWIG3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 2.32% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 1.24% |
| VANESSA L VOWLES3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 1.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Float revenue; Insurance services; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 600 E LAFAYETTE DETROIT, MI 48226 | $107K |
| AMY M ROUSCH HELWIG AGENT/BROKER | Other commissions; Other fees; Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 225 KENNETH DRIVE ROCHESTERD, NY 14623 | $3K |
| PAYCHEX INSURANCE AGENCY INC. AGENT/BROKER | Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions; Other fees; Insurance agents and brokers Service code 22 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | $2K |
| VANESSA L VOWLES AGENT/BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions; Other fees; Non-monetary compensation Service code 22 | 225 KENNETH ROCHESTER, NY 14623 | $2K |
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 | 78 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 78 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 223 | $128K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 223 | $128K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 223 | $128K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 223 | $128K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 223 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.