| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS H ROEHM3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 483078307 | BLUE CARE NETWORK OF MICHIGAN | $35K | $0 | $35K | 4.82% |
| ACTION BENEFITS COMPANY3 | 25800 NORTHWESTERN HWY SUITE 6 SOUTHFIELD, MI 480758075 | BLUE CARE NETWORK OF MICHIGAN | $1K | $0 | $1K | 0.19% |
| AFFILIATED AGENCIES LLC3 | 31730 HOOVER RD STE C WARREN, MI 484808480 | BLUE CARE NETWORK OF MICHIGAN | $0 | $746 | $746 | 0.10% |
| DOUGLAS H ROEHM3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 483078307 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $0 | $10K | 4.94% |
| ACTION BENEFITS COMPANY3 | 25800 NORTHWESTERN HWY SUITE 6 SOUTHFIELD, MI 480758075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $263 | $0 | $263 | 0.13% |
| AFFILIATED AGENCIES LLC3 | 31730 HOOVER RD STE C WARREN, MI 484808480 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $96 | $96 | 0.05% |
| AFFILIATED AGENCIES LLC3 Filed as: AFFILIATED AGENCIES, LLC | 245 BARCLAY CIRCLE STE 200 ROCHESTER, MI 48307 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 6.11% |
| AFFILIATED AGENCIES LLC3 | 245 BARCLAY CIR STE 200 ROCHESTER HILLS, MI 483075814 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.77% |
| ACRISURE LLC3 | 4204 MARTIN ROAD SUITE AB WALLED LAKE, MI 48390 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $1K | $0 | $1K | 17.58% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 164 | $923K |
| Dental | DELTA DENTAL OF MICHIGAN | 226 | $80K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 200 | $8K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $49K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $49K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 143 | $49K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 164 | $923K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.