| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN& ASSOCIATES LLC | — | HARTFORD LIFE AND ACCIDENT | $8K | $222 | $9K | 15.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 38-2069753 NONE KNOWN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Non-monetary compensation; Claims processing; Direct payment from the plan; Float revenue; Other fees; Contract Administrator; Consulting (general) Service code 12 | — | $222K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE KNOWN | Direct payment from the plan; Plan Administrator Service code 14 | — | $62K |
| SULLIVAN, WARD, ASHER & PATTON PC NONE KNOWN | Legal; Direct payment from the plan Service code 29 | 25800 NORTHWESTERN HWY. #1000 SOUTHFIELD, MI 480758412 | $29K |
| ASSOCIATION BENEFITS LLC NONE | Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Insurance agents and brokers Service code 22 | 27333 MEADOWBROOK S-200 NOVI, MI 48377 | $20K |
| WRUBEL, WESLEY & COMPANY C.P.A.'S EIN 38-2574238 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $10K |
| UNITED ACTURIAL SERVICES INC. EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
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 | 305 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 137 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 442 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 10 | $42K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 432 | $55K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 10 | $42K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 281 | $197K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 432 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 432 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.