| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS MCGRAW3 | 3331 WEST BIG BEAVER, SUITE 200 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | $18K | $26K | 3.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGRAW WENTWORTH | 3331 WEST BIG BEAVER, SUITE 200 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.31% |
| EHIM3 | 26711 NORTHWESTERN HWY., SUITE 400 SOUTHFIELD, MI 48034 | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | $1K | $5K | $6K | 4.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 WEST BIG BEAVER, SUITE 200 TROY, MI 48084 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 9.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Consulting (general); Float revenue; Other fees; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Direct payment from the plan Service code 12 | 600E LAFAYETTE BLVD. DETROIT, MI 48226 | $86K |
| THOMAS MCGRAW AGENT | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Shareholder servicing fees; Other commissions Service code 22 | 3331 WEST BIG BEAVER S-200 TROY, MI 48084 | $26K |
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 | 128 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 126 | $834K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $93K |
| Prescription drug | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | 130 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.