| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARL R MESSING3 | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $113K | $0 | $113K | 3.57% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $3K | $3K | 0.11% |
| KIMMEL AGENCY INC3 | 1196 INCA TRL LAKE ORION, MI 48362 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.42% |
| KIMMEL AGENCY INC3 | 1196 INCA TRL LAKE ORION, MI 48362 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 13.65% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC | 9903 E 150TH AVE BRIGHTON, CO 80602 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 8.34% |
| KIMMEL AGENCY INC3 | 1196 INCA TRL LAKE ORION, MI 48362 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 6.76% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | SUITE 240, 2000 CHAPEL VIEW BLVD CRANSTON, RI 02920 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $370 | $370 | 0.70% |
| GARY M. MIKLOSOVIC3 Filed as: GARY S. THIRJUNG | 1263 W SQUARE LAKE RD BLOOMFIELD HILLS, MI 48302 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $90 | $0 | $90 | 0.17% |
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 | 258 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 258 | 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 | 491 | $3.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 491 | $3.2M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 172 | $122K |
| Short-term disability(3 contracts, 3 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 258 | $224K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 172 | $122K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 491 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.