| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DENNIS A CAMPBELL3 Filed as: DENNIS A. CAMPBELL | 26026 TELEGRAPH ROAD, SUITE 100 SOUTHFIELD, MI 48033 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $46K | $0 | $46K | 2.25% |
| ELAINE C. COFFMAN3 | 325 NORTH OLD WOODWARD AVENUE SUITE 370 BIRMINGHAM, MI 48009 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $18K | — | $18K | 0.87% |
| PROADVISOR INSURANCE AGY LLC3 Filed as: PROADVISOR INSURANCE AGY, LLC | 26555 EVERGREEN ROAD, SUITE 535 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.11% |
| PROADVISOR INSURANCE LLC3 Filed as: PROADVISOR INSURANCE, LLC | 26026 TELEGRAPH ROAD, SUITE 100 SOUTHFIELD, MI 48033 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 6.68% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.23% |
| DMC BENEFITS INC3 Filed as: DMC BENEFITS, INC. | 1485 PRINCE CHARLES AVENUE WESTLAKE, OH 44145 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 2.75% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 1.95% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | PO BOX 736061 CHICAGO, IL 60673 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 1.54% |
| RALPH C WILSON AGENCY INC3 Filed as: RALPH C.WILSON AGENCY, INC. | PO BOX 5069 26026 TELEGRAPH ROAD, SUITE 100 SOUTHFIELD, MI 48086 | DELTA DENTAL OF MICHIGAN | $3K | $0 | $3K | 1.50% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 0.98% |
| TRACY KATZ LLC4 Filed as: TRACY KATZ, LLC | 1662 EAST MELTON ROAD BIRMINGHAM, MI 48009 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $968 | — | $968 | 19.95% |
No Schedule C service providers reported on this filing.
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 | 277 | 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) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 469 | $2.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 461 | $196K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 469 | $2.0M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $219K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $219K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 277 | $219K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 504 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.