| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS G. GORE1 | 36423 EGAN CLINTON TOWNSHIP, MI 48035 | PRIORITY HEALTH | $29K | $0 | $29K | — |
| THOMAS G. GORE3 | 36423 EGAN CLINTON TOWNSHIP, MI 48035 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | — |
| CHELTEN BENEFITS GROUP2 Filed as: CHELTEN BENEFITS GROUP AGENCY INC | 4768 PARKVIEW DRIVE CLARKSTON, MI 48346 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | — |
| NATIONAL GENERAL NSM SALES CORP1 Filed as: NATIONAL GENERAL NSM SALES GROUP | 100 NW COMPTON DRIVE STE 200 HILLSBORO, OR 97006 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | — |
| EVETTE SUSAN KENDZIERSKI1 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $23 | $0 | $23 | — |
| KENNETH JAMES BOWERY2 | 18810 WOODS DRIVE W CLINTON TOWNSHIP, MI 48036 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $1 | $0 | $1 | — |
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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 154 | $0 |
| Dental | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 158 | $0 |
| Vision | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 158 | $0 |
| Life insurance | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 158 | $0 |
| Short-term disability | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 158 | $0 |
| Long-term disability | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 158 | $0 |
| Prescription drug | PRIORITY HEALTH | 154 | $0 |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | 2 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.