| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIAN LOWELL3 | 2 CORPORATE DRIVE SHELTON, CT 06484 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $35K | $0 | $35K | 1.95% |
| GREGORY T. SUDDERTH3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 483078307 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | $0 | $13K | 0.74% |
| SEAN J RABINOWITZ3 | 2 CORPORATE DRIVE SHELTON, CT 064846484 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $0 | $4K | 0.24% |
| CROSS BENEFIT SOLUTIONS3 | 116 COMMUNITY DR AUGUSTA, ME 043340004 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.95% |
| ACBI, INC.3 Filed as: ACBI INC DBA ACBI INSURANCE | 2 CORPORATE DR STE 335 SHELTON, CT 064846246 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.20% |
| AFFILIATED AGENCIES LLC3 | 245 BARCLAY CIR STE 200 ROCHESTER HILLS, MI 483075814 | PRINCIPAL LIFE INSURANCE COMPANY | $405 | — | $405 | 0.54% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.47% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.33% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC CONNECTICUT | PO BOX 1388 BANGOR, ME 04402 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.31% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | STANDARD INSURANCE COMPANY | $582 | $0 | $582 | 0.98% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC CONNECTICUT | PO BOX 1388 BANGOR, ME 04402 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.44% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.39% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.38% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | STANDARD INSURANCE COMPANY | $625 | $0 | $625 | 1.18% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC CONNECTICUT | PO BOX 1388 BANGOR, ME 04402 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 4.26% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 3.64% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.43% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | STANDARD INSURANCE COMPANY | $722 | $0 | $722 | 1.52% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC CONNECTICUT | PO BOX 1388 BANGOR, ME 04402 | STANDARD INSURANCE COMPANY | $15K | $0 | $15K | 52.84% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 14.06% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $433 | $0 | $433 | 1.55% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | STANDARD INSURANCE COMPANY | $138 | $0 | $138 | 0.50% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $454 | $0 | $454 | 3.30% |
| ACBI, INC.3 Filed as: ACBI INC | 2 CORPORATE DR STE 335 SHELTON, CT 06484 | STANDARD INSURANCE COMPANY | $346 | $0 | $346 | 2.52% |
| CROSS INSURANCE3 Filed as: CROSS INSURANCE, INC CONNECTICUT | PO BOX 1388 BANGOR, ME 04402 | STANDARD INSURANCE COMPANY | $339 | $0 | $339 | 2.47% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | STANDARD INSURANCE COMPANY | $166 | $0 | $166 | 1.21% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 251 | $1.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 244 | $74K |
| Vision | STANDARD INSURANCE COMPANY | 0 | $14K |
| Life insurance | STANDARD INSURANCE COMPANY | 183 | $59K |
| Short-term disability | STANDARD INSURANCE COMPANY | 182 | $53K |
| Long-term disability | STANDARD INSURANCE COMPANY | 183 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 251 | $1.8M |
| Other | STANDARD INSURANCE COMPANY | 85 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.