| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MACQUEEN & ASSOCIATES LLC Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | THE UNION LABOR LIFE INSURANCE COMPANY | $37K | — | $37K | 7.50% |
| MACQUEEN & ASSOCIATES LLC3 Filed as: MACQUEEN AND ASSOCIATES, LLC | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | MUTUAL OF OMAHA | $27K | $4K | $31K | 11.40% |
| ROBERT EFROS3 | 7300 NORTH BRIARCLIFF KNOLL WEST BLOOMFIELD, MI 48322 | THE UNION LABOR LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ENVISION PHARMACEUTICAL EIN 05-0570786 NONE | Claims processing; Contract Administrator Service code 12 | 2181 E. AURORA RD STE 201 TWINSBURG, OH 44087 | $3.8M |
| DELTA DENTAL PLAN OF MICHIGAN EIN 38-1791480 NONE | Insurance services Service code 23 | PO BOX 30416 LANSING, MI 489097916 | $1.0M |
| BENESYS INC EIN 38-3507129 PLAN ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Plan Administrator; Claims processing Service code 12 | 700 TOWER DRIVE SUITE 300 TROY, MI 48098 | $480K |
| THE UNION LABOR LIFE INSURANCE CO EIN 13-1423090 NONE | Insurance services Service code 23 | ONE STREET NORTHWEST WASHINGTON, DC 20001 | $394K |
| MUTUAL OF OMAHA EIN 47-0246511 NONE | Insurance services Service code 23 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | $276K |
| HEALTH ALLIANCE PLAN OF MICHIGAN EIN 38-2242827 NONE | Contract Administrator Service code 13 | 2850 W. GRAND BLVD DETROIT, MI 48202 | $207K |
| PREMIER HEALTHCARE EXCHANGE EIN 86-1040704 NONE | Contract Administrator Service code 13 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $131K |
| AMERICARE MEDICAL INC. EIN 38-2364792 NONE | Other services Service code 49 | 1938 WOODSLEE DRIVE TROY, MI 48083 | $51K |
| PURE HEALTHY BACK EIN 38-3595479 NONE | Other services Service code 49 | 1500 W BIG BEAVER ROAD, SUITE 150 TROY, MI 48084 | $47K |
| HEALTH DESIGN ENTERPRISES LLC EIN 38-3607439 NONE | Contract Administrator Service code 13 | 1550 E BELT LINE SE GRAND RAPIDS, MI 49506 | $37K |
| SULLIVAN WARD ASHER AND PATTON PC EIN 38-1956491 NONE | Legal Service code 29 | 25800 NORTHWESTERN HIGHWAY SOUTHFIELD, MI 48075 | $34K |
| WORK LIFE STRATEGIES EIN 80-0178558 NONE | Consulting (pension) Service code 17 | PO BOX 670444 DALLAS, TX 75367 | $33K |
| FIFTH THIRD BANK EIN 31-1051736 NONE | Custodial (securities) Service code 19 | 1000 TOWN CENTER SUITE 1500 SOUTHFIELD, MI 480751000 | $28K |
| GOLDEN DENTAL PLANS INC EIN 38-2724203 NONE | Insurance services Service code 23 | 29377 HOOVER ROAD WARREN, MI 48093 | $27K |
| MEDTIPSTER EIN 26-2894721 NONE | Contract Administrator Service code 13 | 24370 NORTHWESTERN HIGHWAY STE 250 SOUTHFIELD, MI 480751000 | $27K |
| DAVIS VISION INC EIN 11-3051991 NONE | Insurance services Service code 23 | 711 TROY-SCHENECTADY RD LATHAM, NY 12110 | $23K |
| MACQUEEN INSURANCE GROUP EIN 20-0495393 NONE | Insurance services Service code 23 | 2191 TWELVE MILE ROAD BERKLEY, MI 48072 | $22K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Insurance services Service code 23 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $16K |
| THE SEGAL COMPANY INC. EIN 13-1975125 NONE | Actuarial Service code 11 | 101 NORTH WACKER DRIVE SUITE 500 CHICAGO, IL 60606 | $14K |
| AMERICAN GRAPHICS EIN 38-2090931 NONE | Copying and duplicating Service code 36 | 34895 GROSEBECK HIGHWAY CLINTON TOWNSHIP, MI 48035 | $12K |
| WALTER, BOESKY & ASSOCIATES P.C. EIN 38-3629743 NONE | Accounting (including auditing) Service code 10 | 17320 W. 12 MILE ROAD STE 200 SOUTHFIELD, MI 480762105 | $12K |
| ALAN D BILLER & ASSOCIATES EIN 94-2854958 NONE | Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD ROAD SUITE 230 MENLO PARK, CA 94025 | $8K |
| TRUVERIS INC. EIN 27-4345686 NONE | Consulting (general) Service code 16 | 515 GREENWICH STREET STE 200 NEW YORK, NY 10013 | $6K |
| INTERNATIONAL FOUNDATION EIN 39-1034021 NONE | Other fees Service code 99 | 18700 W BLUEMOUND ROAD BROOKFIELD, WI 53045 | $6K |
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 | 1,379 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 5,394 | $1.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 925 | $140K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA | 1,113 | $361K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,596 | $497K |
| Other(2 contracts, 2 carriers) | HAP PREFERRED INC. | 4,373 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,394 | — |
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.