| 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 | $22K | — | $22K | 3.49% |
| MACQUEEN & ASSOCIATES LLC3 | 2191 TWELVE MILE RD BERKLEY, MI 48072 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Float revenue; Contract Administrator; Claims processing; Other fees Service code 12 | P.O. BOX 288 DETROIT, MI 48231 | $717K |
| NOVARA, TESIJA & CATENACCI PLLC EIN 38-3763096 NONE | Direct payment from the plan; Legal Service code 29 | 2000 TOWN CENTER STE 2370 SOUTHFIELD, MI 480751314 | $205K |
| UNION SERVICES AGENCY NONE | Direct payment from the plan; Insurance agents and brokers; Insurance services Service code 22 | 119 PERE MARQUETTE DRIVE LANSING, MI 48912 | $62K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | 11590 NORTH MERIDIAN ST CARMEL, IN 46032 | $59K |
| AMERICAN REALTY ADVISORS NONE | Investment management; Direct payment from the plan; Custodial (securities); Investment advisory (plan); Investment management fees paid directly by plan Service code 19 | 801 NORTH BRAND BOULEVARD 818-545-1152 GLENDALE, CA 91203 | $27K |
| COMERICA BANK EIN 41-1741646 NONE | Direct payment from the plan; Other services; Custodial (securities); Investment management; Investment management fees paid directly by plan; Shareholder servicing fees; Other investment fees and expenses Service code 19 | 411 W. LAFAYETTE DETROIT, MI 48226 | $22K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Plan Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | 6525 CENTURION DRIVE LANSING, MI 48917 | $20K |
| BULTYNCK & CO., P.L.L.C. EIN 20-3920878 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 15985 CANAL ROAD CLINTON TOWNSHIP, MI 48038 | $14K |
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 | 720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 145 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 865 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 804 | $631K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 754 | $41K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 754 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 804 | $631K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 804 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 804 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.