| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON E ROSENFELD3 Filed as: JASON BROOKS | 27750 STANSBURY #100 FARMINGTON HILLS, MI 483343803 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | — | $15K | 2.20% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD. SUITE 400 SOUTHFIELD, MI 480768076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 0.82% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM A. LEY | 2401 W. BIG BEAVER RD. S400 TROY, MI 480848084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.28% |
| INSURANCE CONSULTING ASSOCIATES LLC3 Filed as: INSURANCE CONSULTING ASSOCIATES, | LLC 27750 STANSBURY #100 FARMINGTON HILLS, MI 483343803 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $153 | $153 | 0.02% |
| JASON E ROSENFELD3 Filed as: JASON BROOKS | 27750 STANSBURY #100 FARMINGTON HILLS, MI 483343803 | BLUE CARE NETWORK OF MICHIGAN | $12K | — | $12K | 2.03% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD. SUITE 400 SOUTHFIELD, MI 480768076 | BLUE CARE NETWORK OF MICHIGAN | $5K | — | $5K | 0.79% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM A. LEY | 2401 W. BIG BEAVER RD. S400 TROY, MI 480848084 | BLUE CARE NETWORK OF MICHIGAN | $3K | — | $3K | 0.55% |
| INSURANCE CONSULTING ASSOCIATES LLC3 Filed as: INSURANCE CONSULTING ASSOCIATES, | LLC 27750 STANSBURY #100 FARMINGTON HILLS, MI 483343803 | BLUE CARE NETWORK OF MICHIGAN | — | $215 | $215 | 0.04% |
| INSURANCE CONSULTING ASSOCIATES LLC3 Filed as: INSURANCE CONSULTING ASSOCIATES, | LLC 27750 STANSBURY BLVD. STE. 100 FARMINGTON HILLS, MI 483343803 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $2K | $10K | 5.68% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 2401 W. BIG BEAVER RD. STE. 400 TROY, MI 480843327 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 2.85% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 2401 WEST BIG BEAVER ROAD TROY, MI 480843327 | EYEMED VISION CARE | $519 | — | $519 | 5.01% |
| BROOKS FINANCIAL GROUP, INC.3 Filed as: BROOKS FINANCIAL | 30600 NORTHWESTERN HWY. FARMINGTON HILLS, MI 483343171 | EYEMED VISION CARE | $514 | — | $514 | 4.96% |
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 | 122 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 122 | 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 | 122 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $168K |
| Vision | EYEMED VISION CARE | 202 | $10K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $168K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $168K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 120 | $168K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 122 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.