| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL KAHLER3 | 25900 W. 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348034 | BLUE CARE NETWORK OF MICHIGAN | $41K | — | $41K | 4.82% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MI LLC | 25900 W. 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348034 | BLUE CARE NETWORK OF MICHIGAN | — | $913 | $913 | 0.11% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 8.19% |
| ROY LAMPHIER3 | 11 CAMBRIDGE BLVD PLEASANT RIDGE, MI 48069 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.31% |
| PAUL KAHLER3 | 25900 W. 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 4.92% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MI LLC | 25900 W. 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $23 | $23 | 0.04% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 15.39% |
| J.S. CLARK AGENCY, INC.3 Filed as: J. S. CLARK AGENCY, INC | 25900 W. 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.30% |
| J.S. CLARK AGENCY, INC.3 | C/O FRANKLIN BANK 25900 W. 11 MILE RD, SUITE 210 SOUTHFIELD, MI 480348034 | VISION SERVICE PLAN | $1K | — | $1K | 5.62% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $808 | $3K | 20.25% |
| J.S. CLARK AGENCY, INC.3 | 25900 W 11 MILE RD STE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $818 | $2K | 15.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PAUL KAHLER AGENT | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other commissions; Other fees Service code 22 | 25900 W 11 MILE RD STE210 SOUTHFIELD, MI 480348034 | $44K |
| J.S. CLARK AGENCY, INC. AGENT | Other fees; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | 25900 W 11 MILE RD STE210 SOUTHFIELD, MI 480348034 | $25K |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 195 | $904K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $91K |
| Vision | VISION SERVICE PLAN | 70 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $23K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 195 | $904K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.