| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY M ROUSH HELWIG3 Filed as: AMY M. ROUSH HELWIG | PO BOX 948 HENRIETTA, NY 14467 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $53K | $0 | $53K | 2.79% |
| CHRIS CHENG3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | $0 | $7K | 0.34% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $990 | $990 | 0.05% |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 499 | $1.9M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 499 | $1.9M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 499 | $1.9M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 499 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 499 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.