| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RUTH3 | 7276 SNOW APPLE DR. CLARKSTON, MI 483461648 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $24K | $1K | $25K | 0.89% |
| ROBERT G. RUTH3 Filed as: ROBERT RUTH | 7276 SNOW APPLE CLARKSTON, MI 48346 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 3.00% |
| JANELLE M. RUTH3 | 4910 IROQUOIS BLVD. CLARKSTON, MI 48348 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | — | $2K | 5.00% |
| MACQUEEN & ASSOCIATES LLC3 | 2191 12 MILE ROAD BERKLEY, MI 480721825 | MUTUAL OF OMAHA | $3K | $590 | $4K | 12.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Consulting (general) Service code 15 | 700 TOWER DRIVE TROY, MI 48089 | $89K |
| ROOFERS UNION LO. 70 BENEFIT FUNDS EMPLOYEE BENEFIT FUNDS | Other services; Direct payment from the plan Service code 49 | P.O. BOX 766 HOWELL, MI 488440766 | $60K |
| DEBRA SACK EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 253 DARTMOOR WHITMORE LAKE, MI 48189 | $29K |
| LAURA LONDON EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 210 S. NATIONAL HOWELL, MI 48843 | $28K |
| ROOFERS UNION LOCAL 70 PLAN SPONSOR | Direct payment from the plan; Other services Service code 49 | P.O. BOX 116 HOWELL, MI 488440116 | $19K |
| MARK WOODWARD EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 142 BURT JACKSON, MI 49201 | $12K |
| BULTYNCK & CO., P.L.L.C. EIN 20-3920878 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 15985 CANAL ROAD CLINTON TOWNSHIP, MI 48038 | $11K |
| UNION SERVICES AGENCY NONE | Insurance services; Direct payment from the plan Service code 23 | 119 PERE MARQUETTE LANSING, MI 48912 | $10K |
| ROOFERS JOINT EDUCATION TRUST FUND NONE | Other services; Direct payment from the plan Service code 49 | 1660 L STREET N.W. WASHINGTON, DC 20036 | $10K |
| MONROE & ASSOCIATES, INC. NONE | Actuarial; Direct payment from the plan Service code 11 | 25901 W. 10 MILE, STE 200 SOUTHFIELD, MI 48033 | $8K |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 694 | $2.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 656 | $148K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 680 | $32K |
| Life insurance | MUTUAL OF OMAHA | 223 | $29K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 694 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 694 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.