| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 7.34% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 3331 W BIG BEAVER RD SUITE 200 TROY, MI 48084 | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.77% |
| LUBIN SCHWARTZ & GOLDMAN3 | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | VSP | $909 | — | $909 | 3.61% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 3331 W BIG BEAVER RD STE 200 TROY, MI 480842814 | VSP | $288 | — | $288 | 1.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Contract Administrator; Other fees; Direct payment from the plan; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 12 | — | $121K |
| JAY R SCHREIBMAN INVESTMENT BKR | Non-monetary compensation; Other fees; Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 2600 S TELEGRAPH S-100 BLOOMFIELD HILLS, MI 483020333 | $12K |
| REBECCA A MCLAUGHLAN INVESTMENT BKR | Other commissions; Other fees; Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 3331 W BIG BEAVER S-200 TROY, MI 48084 | $5K |
| LSG INSURANCE PARTNERS INVESTMENT BKR | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation; Other fees Service code 22 | 2600 S TELEGRAPH S-100 BLOOMFIELD HILLS, MI 483020333 | $3K |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 148 | $112K |
| Vision | VSP | 135 | $25K |
| Life insurance | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | 193 | $140K |
| Short-term disability | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | 193 | $140K |
| Long-term disability | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | 193 | $140K |
| Other | DEARBOARN NATIONAL LIFE INSURANCE COMPANY | 193 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.