| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD, SUITE 540 CLEVELAND, OH 44131 | RELIASTAR LIFE INSURANCE COMPANY | $14K | $7K | $21K | 7.39% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD, SUITE 540 INDEPENDENCE, OH 44131 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $393 | $8K | 10.29% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC | 12505 CAPITAL OF TEXAS HWY AUSTIN, TX 78746 | METROPOLITAN LIFE INSURANCE COMPANY | $672 | $0 | $672 | 0.83% |
| BLUE CROSS BLUE SHIELD OF FLORIDA5 Filed as: BLUE CROSS BLUE SHIELD OF MICHIGAN | 600 EAST LAFAYETTE BOULEVARD DETROIT, MI 48226 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $101K | $101K | 139.52% |
| JAMES M DUSTIN3 | 4700 ROCKSIDE RD, SUITE 505 INDEPENDENCE, OH 44131 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | $0 | $2K | 3.24% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD, SUITE 540 INDEPENDENCE, OH 44131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $994 | $1K | $2K | 17.40% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD, SUITE 540 INDEPENDENCE, OH 44131 | UNUM INSURANCE COMPANY OF AMERICA | $2K | $243 | $2K | 25.15% |
| THOMAS S FARRO3 Filed as: THOMAS R DETTLING | 3291 STANLEY ROAD AKRON, OH 44333 | HARTFORD LIFE & ACCIDENT COMPANY | $30 | $0 | $30 | 15.08% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 149 | $73K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 149 | $73K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $12K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $91K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $81K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $81K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 149 | $73K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 153 | $287K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.