| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 8.22% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $670 | $3K | 9.32% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $978 | $4K | 12.52% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $248 | $2K | 22.44% |
| JOHN W SCHUEMANN3 | 244 N ROSE ST KALAMAZOO, MI 49007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $30K | $30K | — |
| ANJA HARMON3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $7K | $7K | — |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS | 244 N ROSE ST KALAMAZOO, MI 49007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MI EIN 38-2069753 TPA | Direct payment from the plan; Consulting (general); Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other fees; Insurance services Service code 12 | 600 E LAFAYETTE BLVD DETROIT, MI 48226 | $99K |
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 | 224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 224 | $0 |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 104 | $78K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 104 | $78K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 157 | $32K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 158 | $39K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 224 | $0 |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 93 | $264K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.