| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TMOTHY M DURSO3 | 511 S WASHINGTON AVE LANSING, MI 489331658 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $40K | $4K | $44K | 2.04% |
| ADVANCED INSURANCE MARKETS LTD3 Filed as: ADVANCED INSURANCE MARKETS, LTD | 1969 CEDAR ST HOLT, MI 48842 | DELTA DENTAL OF MICHIGAN | $13K | $0 | $13K | 5.50% |
| CENTENNIAL EMPLOYEE BENEFITS3 Filed as: CENTENNIAL FIN SERVICES | 511 S WASHINGTON AVE LANSING, MI 489332301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 6.12% |
| STEVEN R. ANDERSON3 | 1969 CEDAR STREET HOLT, MI 48842 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.75% |
| STEVEN R. ANDERSON3 | 1969 CEDAR STREET HOLT, MI 48842 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| ADVANCED INSURANCE MARKETS LTD3 | 1969 CEDAR HOLT, MI 48842 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $123 | $0 | $123 | — |
| TONI JACKSON3 | 17341 BIRCHCREST DETROIT, MI 48221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | — |
| CAROL DENISE DONALDSON3 | 1868 BROMLEY LANE ROCHESTER HILLS, MI 48306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | — |
| PATRICIA REED3 | 569 THORNHILL COURT BELLEVILLE, ME 48111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | — |
| CYNTHIA HEGGS3 | 162 WAVERLY HIGHLAND PARK, MI 48203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | — |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 628 | $2.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 659 | $232K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 264 | $74K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $122K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 659 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.