| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 7.06% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.83% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.98% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $669 | $669 | 3.79% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $573 | $573 | 3.40% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $363 | $363 | 3.17% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $247 | $247 | 2.42% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $295 | $295 | 3.37% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $233 | $233 | 3.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Float revenue; Consulting (general); Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Insurance services; Other fees Service code 12 | 600 EAST LAFAYETTE BOULEVARD DETROIT, MI 48226 | $102K |
| JAMES R HAYES AGENT/BROKER | Non-monetary compensation; Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers; Other fees Service code 22 | 31300 PLYMOUTH ROAD LIVONIA, MI 48150 | $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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 187 | $90K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 25 | $9K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.