| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS H ROEHM3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER HILLS, MI 48307 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | $0 | $5K | 2.60% |
| JOHN EICHMANN3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | $0 | $2K | 0.98% |
| AFFILIATED AGENCIES LLC3 | 31730 HOOVER RD STE C WARREN, MI 484808480 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $196 | $196 | 0.11% |
| AFFILIATED AGENCIES, LLC--DOUGLAS R3 | 245 BARCLAY CIRCLE STE 200 ROCHESTER, MI 48307 | DELTA DENTAL OF MICHIGAN | $3K | $135 | $4K | 3.77% |
| VIRTUS LLC--JOHN EICHMANN3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 1.17% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIR STE 200 ROCHESTER HILLS, MI 48307 | PACIFIC LIFE & ANNUITY COMPANY | $6K | $4K | $10K | 16.99% |
| VIRTUS LLC3 | 4550 W 109TH ST STE 300 LEAWOOD, KS 66211 | PACIFIC LIFE & ANNUITY COMPANY | $3K | $0 | $3K | 4.60% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA CUSTOM BENEFITS IN | 4204 MARTIN ROAD SUITE A B WALLED LAKE, MI 48390 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $2K | $0 | $2K | 17.86% |
| STRATEGIC SERVICES GROUP3 | 245 BARCLAY CIR STE 200 ROCHESTER HILLS, MI 48307 | AFLAC | $816 | $0 | $816 | 11.43% |
| AJ BENEFITS INC3 | 7866 SLEEPY HOLLOW DR NORTHVILLE, MI 48168 | AFLAC | $646 | $14 | $660 | 9.25% |
| HILARY R EBNER3 | PO BOX 760431 LATHRUP VILLAGE, MI 48076 | AFLAC | $174 | $3 | $177 | 2.48% |
| JD FINANCIAL SERVICES3 | PO BOX 51494 LIVONIA, MI 48151 | AFLAC | $99 | $0 | $99 | 1.39% |
| SHAUN M KLUG3 | 46389 SPINNING WHEEL DR CANTON, MI 48187 | AFLAC | $83 | $3 | $86 | 1.21% |
| GABRIEL G TORREZ3 | 30800 TELEGRAPH RD STE 1950 BINGHAM FARMS, MI 48025 | AFLAC | $40 | $0 | $40 | 0.56% |
| JAMES C SNIDER JR3 | 4105 MILLSTREAM RD DENVER, NC 28037 | AFLAC | $29 | $0 | $29 | 0.41% |
| MICHAEL RITTER3 Filed as: MICHAEL F RITTER | 550 FOREST AVE STE 15-2 PLYMOUTH, MI 48170 | AFLAC | $25 | $0 | $25 | 0.35% |
| PATRICE C DITRAPANI3 | 3140 WALNUT HLS LEONARD, MI 48367 | AFLAC | $24 | $0 | $24 | 0.34% |
| HEIDI E GLAUB3 | 19321 WIND DANCER ST LUTZ, FL 33558 | AFLAC | $7 | $0 | $7 | 0.10% |
| JANEEN FLORES3 Filed as: JANEEN M FLORES | 109 MILL HOUSE DR OAKLAND, MI 48363 | AFLAC | $6 | $0 | $6 | 0.08% |
| MARK A LINSNER3 | 1712 AUSTIN LN ST AUGUSTINE, FL 32092 | AFLAC | $6 | $0 | $6 | 0.08% |
| THOMAS W BOSTON3 Filed as: THOMAS A DANKO | 71550 ELDRED RD BRUCE TWP, MI 48065 | AFLAC | $5 | $0 | $5 | 0.07% |
| SPAZ AND GLAUB ENTERPRISES3 | 535 SANCTUARY DR APT A202 LONGBOAT KEY, FL 34228 | AFLAC | $5 | $0 | $5 | 0.07% |
| RICHARD P SOMMERS3 | 861 AUGUSTA DR ROCHESTER, MI 48309 | AFLAC | $3 | $0 | $3 | 0.04% |
| AG AND ASSOCIATES3 | 535 SANCTUARY DR APT A202 LONGBOAT KEY, FL 34228 | AFLAC | $3 | $0 | $3 | 0.04% |
| MICHELLE R CALVIN3 | PO BOX 99 JONESVILLE, MI 49250 | AFLAC | $1 | $0 | $1 | 0.01% |
| RANDALL L KIMBLER3 | PO BOX 302 HESPERIA, MI 49421 | AFLAC | $1 | $0 | $1 | 0.01% |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 192 | $1.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 233 | $94K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 203 | $9K |
| Life insurance | PACIFIC LIFE & ANNUITY COMPANY | 126 | $58K |
| Short-term disability | PACIFIC LIFE & ANNUITY COMPANY | 126 | $58K |
| Long-term disability | PACIFIC LIFE & ANNUITY COMPANY | 126 | $58K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 192 | $1.3M |
| Other | AFLAC | 17 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.