| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH A KING3 | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN, | $2K | $161 | $2K | 3.39% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN, | $2K | — | $2K | 3.61% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | DELTA DENTAL OF MICHIGAN, | $1K | — | $1K | 4.56% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | RELIANCE STANDARD, | $463 | — | $463 | 2.34% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | RELIANCE STANDARD, | $477 | — | $477 | 4.85% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | EYE MED, | $387 | — | $387 | 9.53% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DR MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY, | $306 | $159 | $465 | 14.21% |
| TIMBERLAND GROUP SERVICES, INC.3 Filed as: TIMBERLAND GROUP SERVICES | 1707 W. BIG BEAVER ROAD TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY, | $309 | — | $309 | 9.44% |
| DIANNA LYNN ATCHISON3 | 15130 SNOWBERRY CT SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY, | $85 | $6 | $91 | 2.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Float revenue; Insurance services; Consulting (general); Claims processing; Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $18K |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN, | 21 | $51K |
| Dental | DELTA DENTAL OF MICHIGAN, | 337 | $22K |
| Vision | EYE MED, | 350 | $4K |
| Life insurance | RELIANCE STANDARD, | 169 | $10K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY, | 10 | $3K |
| Long-term disability | RELIANCE STANDARD, | 169 | $20K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN, | 21 | $51K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN, | 288 | $54K |
| Other | RELIANCE STANDARD, | 169 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.