| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREGG GOODMAN3 Filed as: GREGG M GOODMAN | 11590 N MERIDIAN STE 600 CARMEL, IN 46032 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $3K | $17K | 0.19% |
| MACQUEEN INSURANCE GROUP3 Filed as: MACQUEEN & ASSOC LLC | 2191 TWELVE MILE RD BERKLEY, MI 48072 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Other fees; Float revenue; Claims processing; Contract Administrator; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Accounting (including auditing) Service code 10 | PO BOX 288 DETROIT, MI 48231 | $540K |
| NOVARA TESIJA PLLC EIN 38-3763096 NONE | Legal; Direct payment from the plan Service code 29 | 2000 TOWN CENTER STE 2370 SOUTHFIELD, MI 480751314 | $114K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 14 | 6525 CENTURION DRIVE LANSING, MI 490179275 | $41K |
| UNITED ACTUARIAL SERVICES EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | 11590 NORTH MERIDIAN ST CARMEL, IN 46032 | $25K |
| HUNGERFORD NICHOLS EIN 38-2184825 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 2910 LUCERNE DRIVE SE GRAND RAPIDS, MI 49546 | $23K |
| COMERICA BANK EIN 41-1741646 NONE | Investment advisory (plan); Investment management fees paid directly by plan; Custodial (securities); Other investment fees and expenses; Investment management; Direct payment from the plan Service code 19 | 411 W LAFAYETTE DETROIT, MI 48226 | $21K |
| AMERICAN CORE REALTY NONE | Custodial (securities); Investment management fees paid directly by plan; Investment management; Direct payment from the plan; Investment advisory (plan) Service code 19 | 801 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | $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 | 693 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 152 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 845 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 0 | $8.9M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 820 | $41K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 0 | $8.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 820 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.