| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF INDIANA | 111 E WAYNE ST., STE. 310 FORT WAYNE, IN 468022600 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $6K | $19K | 13.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 MEDICAL TPA | Claims processing; Insurance services; Direct payment from the plan; Contract Administrator; Other fees; Float revenue; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $148K |
| HILB GROUP MIDWEST BROKER | Other commissions; Insurance agents and brokers; Other fees; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 45600 VILLAGE BLVD. SHELBY TOWNSHIP, MI 48315 | $12K |
| STRATEGIC BENEFITS NETWORK LLC BROKER | Insurance agents and brokers; Non-monetary compensation; Other commissions; Insurance brokerage commissions and fees; Other fees Service code 22 | 5797 HARVEY ST., STE. A NORTON SHORES, MI 49444 | $2K |
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 | 227 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 302 | $142K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 302 | $142K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 302 | $142K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 302 | $142K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 232 | $333K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 302 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.