| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRENDA R MANNING3 Filed as: BRENDA R. MANNING | 1368 BUSINESS PARK DRIVE TRAVERSE CITY, MI 49686 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 1.48% |
| ROXANNA DIETERLE3 | 2600 SOUTH TELGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 1.45% |
| HIGH STREET INSURANCE PARTNERS, INC3 | 500 GRISWOLD, SUITE 2700 DETROIT, MI 48226 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $775 | $775 | 0.19% |
| BRENDA R MANNING3 Filed as: BRENDA R. MANNING | 1368 BUSINESS PARK DRIVE TRAVERSE CITY, MI 49686 | BLUE CARE NETWORK OF MICHIGAN | $4K | $0 | $4K | 1.46% |
| ROXANNA DIETERLE3 | 2600 SOUTH TELGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $4K | $0 | $4K | 1.45% |
| HIGH STREET INSURANCE PARTNERS, INC3 | 500 GRISWOLD, SUITE 2700 DETROIT, MI 48226 | BLUE CARE NETWORK OF MICHIGAN | $0 | $546 | $546 | 0.22% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR AND ASSOC., INC. | 1368 BUSINESS PARK DRIVE TRAVERSE CITY, MI 49686 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 4.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 3.80% |
| WRIGHT & ASSOCIATES INSURANCE GROUP3 Filed as: WRIGHT AND ASSOCIATES | 401 WEST FRONT STREET, SUITE 4 TRAVERSE CITY, MI 49684 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 2.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 5.06% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR AND ASSOC., INC. | 1368 BUSINESS PARK DRIVE TRAVERSE CITY, MI 49686 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 4.95% |
| HIGH STREET INSURANCE PARTNERS, INC3 | 305 WEST FRONT STREET, SUITE 201 2ND FLOOR TRAVERSE CITY, MI 49684 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 3.46% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN AND ASSOCIATES | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | HARTFORD LIFE AND ACCIDENT | $0 | -$420 | -$420 | -0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $538 | $0 | $538 | 5.73% |
| PETERSON MCGREGOR & ASSOC INC.3 Filed as: PETERSON MCGREGOR AND ASSOC., INC. | 305 WEST FRONT STREET, SUITE 201 TRAVERSE CITY, MI 49684 | VISION SERVICE PLAN | $399 | $0 | $399 | 4.25% |
No Schedule C service providers reported on this filing.
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 92 | $643K |
| Dental | DELTA DENTAL OF MICHIGAN | 121 | $48K |
| Vision | VISION SERVICE PLAN | 70 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 104 | $42K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 104 | $42K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 104 | $42K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 92 | $643K |
| Other | HARTFORD LIFE AND ACCIDENT | 104 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.