| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | HEALTH ALLIANCE PLAN | $14K | — | $14K | 3.16% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | HEALTH ALLIANCE PLAN | $6K | — | $6K | 1.24% |
| AMY J HALL3 | 25900 WEST 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | BLUECROSS BLUESHIELD OF MICHIGAN | $11K | $49K | $60K | 23.26% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | BLUECROSS BLUESHIELD OF MICHIGAN | — | $2K | $2K | 0.69% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | STARMOUNT LIFE INSURANCE COMPANY | $21K | $3K | $23K | 11.57% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $2K | $11K | 9.04% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN, LLC | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 16.60% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $1K | — | $1K | 10.18% |
| J.S. CLARK AGENCY, INC.4 Filed as: J S CLARK AGENCY, INC. | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $1K | — | $1K | 9.15% |
| J.S. CLARK AGENCY, INC.3 | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | FOUR EVER LIFE INSURANCE COMPANY | $464 | — | $464 | 15.01% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF MICHIGAN, LLC | 25900 W. 11 MILE ROAD, SUITE 210 SOUTHFIELD, MI 48034 | HARTFORD LIFE AND ACCIDENT | $319 | — | $319 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Direct payment from the plan; Contract Administrator; Claims processing; Insurance services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 12 | — | $166K |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH ALLIANCE PLAN | 357 | $455K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 240 | $201K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 240 | $201K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 280 | $197K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 280 | $117K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF MICHIGAN | 355 | $258K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 283 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.