| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $45K | $21K | $66K | 6.33% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $11K | $24K | 3.57% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $17K | $30K | 11.77% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $6K | $18K | 10.84% |
| ROY LAMPHIER3 | 17901 HAMILTON RD HIGHLAND PARK, MI 48203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 8.48% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $11K | $17K | 10.86% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 16.54% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 17.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CARE NETWORK EIN 38-2359234 TPA | Contract Administrator Service code 13 | 20500 CIVIC CENTER DR SOUTHFIELD, MI 48076 | $1.2M |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Direct payment from the plan; Claims processing; Consulting (general); Contract Administrator; Insurance services; Float revenue Service code 12 | 600 E. LAFAYETTE BLVD DETROIT, MI 48226 | $589K |
| ANTHONY J DARE JR NONE | Other commissions; Other fees; Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 28411 NORTHWESTERN STE SOUTHFIELD, MI 48034 | $267K |
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 | 1,425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 143 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,568 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,007 | $676K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,669 | $425K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,448 | $1.0M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 379 | $156K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,669 | $255K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,007 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.