| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY J HALL3 | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | $14K | — | $14K | 2.53% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD SUITE 400 SOUTHFIELD, MI 48076 | BLUE CARE NETWORK OF MICHIGAN | $5K | — | $5K | 0.97% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY | 25900 W ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $3K | $6K | 11.59% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $609 | — | $609 | 1.25% |
| LUCIDO MORRIS ASSOCIATES, LLC3 | 24255 W 13 MILE ROAD SUITE 250 BINGHAM FARMS, MI 48025 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $50 | — | $50 | 0.10% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY, INC. | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $266 | $0 | $266 | 1.00% |
| USI INSURANCE SERVICES LLC3 | 1 SEAGATE SUITE 1800 TOLEDO, OH 43604 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $226 | $0 | $226 | 0.85% |
| FERRIS, MARK3 | 3400 EXECUTIVE PARKWAY TOLEDO, OH 43006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $176 | $0 | $176 | 0.66% |
| AMY J HALL3 | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $271 | $0 | $271 | 1.41% |
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD SUITE 400 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $161 | — | $161 | 0.84% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $205 | $3K | 16.25% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY | 25900 W ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $208 | — | $208 | 2.29% |
| USI INSURANCE SERVICES LLC3 | 1 SEAGATE SUITE 1800 TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $177 | — | $177 | 1.95% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY, INC. | 25900 W ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $827 | $103 | $930 | 11.25% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY | 25900 W ELEVEN MILE ROAD SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $947 | $79 | $1K | 16.25% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | HERITAGE VISION PLANS INC | $558 | — | $558 | 9.65% |
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 | 147 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 126 | $557K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 65 | $49K |
| Vision | HERITAGE VISION PLANS INC | 53 | $6K |
| Life insurance(4 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 147 | $60K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 19 | $6K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 126 | $557K |
| Other(4 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 147 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.