| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH A KING3 Filed as: JOSEPH A. KING | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $1K | $11K | 2.18% |
| JAMES R. HAYES3 | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 1.47% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES INC. | — | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 2.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 38-2069753 NONE | Consulting (general); Claims processing; Direct payment from the plan; Contract Administrator; Other fees; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $246K |
| BENESYS EIN 38-2383171 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $63K |
| LEGACY PARTNERS INSURANCE SERVICES NONE | Insurance services; Consulting fees; Direct payment from the plan Service code 23 | 33304 GRAND RIVER FARMINGTON, MI 48336 | $21K |
| TIMBERLAND GROUP SERVICES INC NONE | Consulting fees; Direct payment from the plan; Insurance services Service code 23 | 1707 WEST BIG BEAVER ROAD TROY, MI 48084 | $21K |
| PNC BANK NONE | Account maintenance fees; Direct payment from the plan Service code 50 | ONE FINACIAL PARKWAY KALAMAZOO, MI 49009 | $16K |
| SACHS WALDMAN PC EIN 38-1905521 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
| THE SEGAL COMPANY EIN 06-0839113 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $11K |
| MORGAN STANLEY SMITH BARNEY EIN 13-2655998 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $10K |
| ENVISION PHARMACEUTICAL SERVICES EIN 05-0570786 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $10K |
| WRUBEL, WESLEY & CO CPA'S EIN 38-2574238 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $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 | 271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 106 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 117 | $460K |
| Dental | DELTA DENTAL OF MICHIGAN | 877 | $305K |
| Life insurance | UNION LABOR LIFE INSURANCE COMPANY | 245 | $25K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 842 | $498K |
| Other | UNION LABOR LIFE INSURANCE COMPANY | 245 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 877 | — |
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."
No prospect flags tripped on this filing.