| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL KAHLER3 | 25900 W 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348203 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | $21K | $40K | 1.48% |
| J.S. CLARK AGENCY, INC.3 Filed as: J.S. CLARK AGENCY DBA OF ASSURED | 25900 W 11 MILE ROAD, STE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 0.13% |
| PAUL KAHLER3 | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.76% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD, SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 15.74% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD, SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 10.72% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN | 25900 W. ELEVEN MILE, SUITE 210 SOUTHFIELD, MI 480348203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 20.00% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD, SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.76% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD, SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Claims processing; Other fees; Insurance services; Contract Administrator; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $133K |
| J.S. CLARK AGENCY, INC. EIN 38-2725572 AGENT | Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Other commissions; Insurance agents and brokers Service code 22 | 25900 W 11 MILE, STE 210 SOUTHFIELD, MI 480348203 | $31K |
| PAUL KAHLER AGENT | Other fees; Insurance agents and brokers; Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 25900 W 11 MILE, STE 210 SOUTHFIELD, MI 480348203 | $28K |
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 | 295 | 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) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 284 | $2.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 295 | $159K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 284 | $2.7M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $45K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $68K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $42K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 284 | $2.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 149 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.