| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES R. HAYES3 | 13900 LAKESIDE CIRCLE STERLING HEIGHTS, MI 48313 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $36K | $0 | $36K | 2.95% |
| JAMES R. HAYES3 | 13900 LAKESIDE CIRCLE STERLING HEIGHTS, MI 48313 | BLUE CARE NETWORK OF MICHIGAN | $15K | $0 | $15K | 2.96% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 39833 BRIDGEVIEW STREET HARRISON TOWNSHIP, MI 48045 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 4.15% |
| ASSUREDPARTNERS3 | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $887 | $0 | $887 | 0.65% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 39833 BRIDGEVIEW STREET HARRISON, MI 48045 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 8.58% |
| ASSUREDPARTNERS3 | 25900 WEST 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.67% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 31300 PLYMOUTH ROAD LIVONIA, MI 48150 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.64% |
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 | 149 | 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) | 149 | 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 | 186 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 229 | $137K |
| Vision | VISION SERVICE PLAN | 94 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $100K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $100K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $100K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.