| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOEL CLARK3 | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | $29K | — | $29K | 1.80% |
| ASSUREDPARTNERS3 Filed as: JS CLARK AGENCY DBA ASSUREDPARTNERS | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | BLUE CARE NETWORK OF MICHIGAN | — | $862 | $862 | 0.05% |
| JOEL CLARK3 | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | — | $6K | 1.60% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY DBA ASSURED PARTNER | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $104 | $104 | 0.03% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY, INC | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $5K | $9K | 10.98% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 20.08% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.22% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY, INC. | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY / EYEMED VISION CARE | $2K | — | $2K | 8.99% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY / EYEMED VISION CARE | $188 | — | $188 | 0.89% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $563 | $2K | 13.03% |
| ROY LAMPHIER3 | 11 CAMBRIDGE BLVD PLEASANT RIDGE, MI 48069 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 178 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 335 | $2.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 40 | $359K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY / EYEMED VISION CARE | 311 | $21K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $78K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $21K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 335 | $2.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 77 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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.