| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENESYS INC5 Filed as: BENESYS, INC. | 700 TOWER DRIVE, SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY | $256K | — | $256K | 5.31% |
| BENESYS INC3 Filed as: BENESYS, INC. | 700 TOWER DRIVE TROY, MI 48098 | DELTA DENTAL OF MICHIGAN | — | — | $0 | 0.00% |
| BENESYS INC3 Filed as: BENESYS, INC. | 700 TOWER DRIVE TROY, MI 48098 | DELTA DENTAL OF MICHIGAN | — | — | $0 | 0.00% |
| BENESYS INC5 Filed as: BENESYS, INC. | 700 TOWER DRIVE, SUITE 300 TROY, MI 480982385 | HUMANA HEALTH INSURANCE CO. OF FLORIDA, INC. | $2K | — | $2K | 5.16% |
| BENESYS INC5 Filed as: BENESYS, INC. | 700 TOWER DRIVE, SUITE 300 TROY, MI 48098 | HUMANA BENEFIT PLAN OF ILLINOIS, INC. | $300 | — | $300 | 5.26% |
| BENESYS INC5 Filed as: BENESYS, INC. | 700 TOWER DRIVE, SUITE 300 TROY, MI 48098 | HUMANA INSURANCE COMPANY OF NEW YORK | $100 | — | $100 | 4.76% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | HCC LIFE INSURANCE COMPANY | $27K | — | $27K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Plan Administrator; Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 700 TOWER DR, SUITE 300 TROY, MI 48098 | $1.8M |
| HEALTH ALLIANCE PLAN EIN 38-2242827 NONE | Direct payment from the plan; Claims processing Service code 12 | 2850 WEST GRAND BLVD DETROIT, MI 48202 | $690K |
| PREMIER HEALTHCARE EXCHANGE EIN 86-1040704 NONE | Direct payment from the plan; Consulting (general) Service code 16 | 2 CROSSROADS DR BEDMINSTER, NJ 07921 | $213K |
| CARPENTERS FRINGE BENEFIT FUNDS JDC EIN 38-3345174 NONE | Other services; Direct payment from the plan Service code 49 | 22260 HAGGERTY RD STE 350 NORTHVILLE, MI 48167 | $170K |
| NOVARA TESIJA, PLLC EIN 38-3763096 NONE | Legal; Direct payment from the plan Service code 29 | 2000 TOWN CENTER STE 2370 SOUTHFIELD, MI 48075 | $169K |
| AMERICAN HEALTH HOLDING NONE | Consulting (general); Direct payment from the plan Service code 16 | 7400 W. CAMPUS ROAD F-510 NEW ALBANY, OH 43054 | $156K |
| AMERICARE NONE | Other services; Direct payment from the plan Service code 49 | 1938 WOODSLEE DRIVE TROY, MI 48083 | $137K |
| AMERICAN GRAPHICS PRINTING CO EIN 38-2090931 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 34895 GROESBECK HWY CLINTON TOWNSHIP, MI 48035 | $89K |
| UNION SERVICES AGENCY NONE | Insurance agents and brokers; Insurance services; Direct payment from the plan Service code 22 | 119 PERE MARQUETTE DRIVE 517-482-6700 LANSING, MI 48912 | $52K |
| EVOLUTION1, INC. EIN 06-1593514 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 22 WATERVILLE RD AVON, CT 06001 | $47K |
| BULTYNCK & CO., PLLC EIN 20-3920878 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 15985 CANAL ROAD CLINTON TOWNSHIP, MI 48038 | $36K |
| HINES AND ASSOCIATES NONE | Direct payment from the plan; Consulting (general) Service code 16 | 631 E BIG BEAVER RD TROY, MI 48083 | $36K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | 11590 N. MERIDIAN STE 610 CARMEL, IN 460324529 | $16K |
| BOYD WATTERSON ASSET MANAGEMENT NONE | Securities brokerage; Direct payment from the plan; Investment management; Investment management fees paid directly by plan; Custodial (securities); Investment advisory (plan) Service code 19 | 1801 EAST 9TH STREET 216-771-3450 CLEVELAND, OH 441143179 | $13K |
| MORGAN STANLEY SMITH BARNEY EIN 13-2919773 NONE | Investment management; Custodial (securities); Investment management fees paid directly by plan; Investment advisory (plan); Securities brokerage; Direct payment from the plan; Named fiduciary Service code 19 | 101 W.BIG BEAVER RD S1200 TROY, MI 48084 | $7K |
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 | 3,424 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,400 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,824 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 9,850 | $1.9M |
| Prescription drug(4 contracts, 4 carriers) | HUMANA INSURANCE COMPANY | 2,430 | $4.9M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,850 | — |
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.