| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EARL JEFFREY SAMS3 | P.O. BOX 1748 SAGINAW, MI 486051748 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $46K | — | $46K | 4.90% |
| GROTENHUIS3 | P.O. BOX 140167 GRAND RAPIDS, MI 495140167 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 1.08% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S. WASHINGTON SAGINAW, MI 486012509 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $333 | $333 | 0.04% |
| SAGINAW BAY UNDERWRITERS3 | 1258 S. WASHINGTON AVENUE SAGINAW, MI 48605 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 6.13% |
| MICHIGAN CHAMBER SERVICES, INC.3 Filed as: MICHIGAN CHAMBER SERVICE | 600 S. WALNUT STREET LANSING, MI 48933 | VISION SERVICE PLAN INSURANCE COMPANY | — | — | $0 | 0.00% |
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 | 180 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 215 | $931K |
| Dental | DELTA DENTAL OF MICHIGAN | 180 | $63K |
| Vision | VISION SERVICE PLAN INSURANCE COMPANY | 73 | $14K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 215 | $931K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.