| 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 | $118K | — | $118K | 2.88% |
| ROBERT G. RUTH3 Filed as: ROBERT RUTH | 7276 SNOW APPLE CLARKSTON, MI 48346 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 2.71% |
| JANELLE M. RUTH3 | 4910 IROQUOIS BLVD. CLARKSTON, MI 48348 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | — | $2K | 5.00% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN AND ASSOCIATES LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | AMERICAN UNITED LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| ROBERT G. RUTH3 | 7276 SNOW APPLE DR. CLARKSTON, MI 483461648 | BLUE CARE NETWORK OF MICHIGAN | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Consulting (general); Claims processing; Insurance brokerage commissions and fees; Non-monetary compensation; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Other commissions; Insurance services; Insurance agents and brokers; Other fees Service code 12 | 600 E LAFAYETTE ST DETROIT, MI 48226 | $4.2M |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 NONE | Insurance services; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Claims processing; Consulting (general) Service code 12 | 4100 OKEMOS ROAD OKEMOS, MI 48864 | $241K |
| BENESYS, INC. EIN 38-2383171 NONE | Plan Administrator; Direct payment from the plan; Copying and duplicating; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Claims processing; Accounting (including auditing); Contract Administrator Service code 10 | 700 TOWER DRIVE TROY, MI 48089 | $120K |
| BLUE CARE NETWORK OF MICHIGAN EIN 38-2359234 NONE | Claims processing; Other fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services Service code 12 | 20500 CIVIC CENTER DR SOUTHFIELD, MI 48076 | $70K |
| NATIONAL VISION ADMINISTRATORS, LLC EIN 43-0949844 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Consulting (general); Claims processing; Other fees Service code 12 | 1200 US-46 CLIFTON, NJ 07013 | $44K |
| LAURA LONDON EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 210 S NATIONAL HOWELL, MI 48843 | $36K |
| ROOFERS JOINT EDUCATION TRUST FUND EIN 16-6036596 NONE | Direct payment from the plan; Other services Service code 49 | 1660 L STREET NW WASHINGTON, DC 20036 | $31K |
| ONE AMERICA EIN 35-0145825 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Claims processing; Other fees; Insurance services Service code 12 | ONE AMERICAN SQ PO BOX368 INDIANAPOLIS, IN 46206 | $30K |
| BULTYNCK & CO., PLLC EIN 20-3920878 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 15985 CANAL ROAD CLINTON TOWNSHIP, MI 48038 | $13K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance services Service code 22 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $13K |
| MONROE & ASSOCIATES, INC. NONE | Direct payment from the plan; Actuarial Service code 11 | 25901 W 10 MILE STE 200 248-354-6220 SOUTHFIELD, MI 48033 | $11K |
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 | 363 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 390 | 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 | 819 | $4.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 811 | $241K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 823 | $44K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 288 | $28K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 819 | $4.1M |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 288 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 823 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.