| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA5 Filed as: BLUE CROSS BLUE SHIELD OF MICHIGAN | PO BOX 2888 DETROIT, MI 48231 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $88K | $88K | 48.25% |
| WILLIAM R. PAPA3 | 101 WEST BIG BEAVER SUITE 600 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $16K | $22K | 12.20% |
| CAMERON M KENNEDY3 Filed as: CAMERON KENNEDY | 400 W 4TH ST SUITE 300 ROYAL OAK, MI 48067 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $531 | $5K | $6K | 3.30% |
| CAMBRIDGE CONSULTING GROUP LLC3 Filed as: CAMBRIDGE CONSULTING GROUP | 101 WEST BIG BEAVER SUITE 600 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $946 | $946 | 0.52% |
| STEPHEN J HETTRICK3 | 35735 MOUND RD STERLING HEIGHTS, MI 48311 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $531 | — | $531 | 0.29% |
| MICHAEL C WALKER3 Filed as: MICHAEL G BUCK | 38221 MOUND RD STERLING HEIGHTS, MI 48310 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $531 | — | $531 | 0.29% |
| CAMBRIDGE CONSULTING GROUP LLC3 Filed as: CAMBRIDGE CONSULTING GROUP, LLC | 400 W 4TH ST STE 300 ROYAL OAK, MI 48067 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 5.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT INC. | PO BOX 8029 STERLING HEIGHTS, MI 48311 | DELTA DENTAL OF MICHIGAN | $1K | — | $1K | 1.73% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH ST SUITE 300 ROYAL OAK, MI 48067 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $54 | $5K | 16.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 35735 MOUND RD STERLING HEIGHTS, MI 48311 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $883 | — | $883 | 3.27% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH ST SUITE 300 ROYAL OAK, MI 48067 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $16 | $1K | 12.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT, INC. | 35735 MOUND RD STERLING HEIGHTS, MI 48311 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $215 | — | $215 | 2.17% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W FOURTH ST SUITE 300 ROYAL OAK, MI 48067 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $975 | $13 | $988 | 17.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF DETROIT INC. | 35735 MOUND RD STERLING HEIGHTS, MI 48311 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $180 | — | $180 | 3.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATO | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | PO BOX 251568 DETROIT, MI 48231 | $88K |
| WILLIAM R PAPA EIN 38-2568685 INSURANCE AGENT/BROKER | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Other commissions Service code 22 | 38221 MOUND RD BUILDING G STERLING HEIGHTS, MI 48130 | $22K |
| BCI ADMINISTRATORS INC. EIN 38-3349153 ADMINISTRATOR | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | PO BOX 251568 WEST BLOOMFIELD, MI 48325 | $8K |
| CAMERON M KENNEDY INSURANCE AGENT/BROKER | Other fees; Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 400 W 4TH ST SUITE 300 ROYAL OAK, MI 48067 | $6K |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 254 | $72K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 140 | $27K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 19 | $10K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 119 | $183K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 140 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.