| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIMOTHY M DURSO3 | 511 S WASHINGTON AVE LANSING, MI 48933 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $32K | $0 | $32K | 1.61% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | $0 | $12K | 0.60% |
| CENTENNIAL EMPLOYEE BENEFITS3 Filed as: CENTENNIAL ASSOCIATES, INC. | 511 S WASHINGTON AVE LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $9K | $0 | $9K | 4.67% |
| TIM M DURSO3 Filed as: TIM DURSO | 511 SOUTH WASHINGTON AVE LANSING, MI 48933 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $0 | $15K | 8.50% |
| EXTERNAL AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $1K | $0 | $1K | 1.66% |
| MANAGING AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $422 | $0 | $422 | 0.51% |
| CENTENNIAL GROUP BENEFITS3 Filed as: THE CENTENNIAL GROUP | 511 SOUTH WASHINGTON AVENUE LANSING, MI 48933 | EYEMED | $3K | $0 | $3K | 8.90% |
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 | 231 | 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) | 231 | 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 | 487 | $2.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 528 | $191K |
| Vision | EYEMED | 452 | $30K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 370 | $181K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 370 | $181K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 370 | $181K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 487 | $2.1M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 370 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 528 | — |
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.