| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $7K | $7K | 1.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATO | Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Insurance services; Other fees; Contract Administrator; Float revenue Service code 12 | — | $75K |
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $71K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE, INV. MGMT & ADV | Direct payment from the plan; Other investment fees and expenses; Trustee (directed); Investment management; Other fees; Investment advisory (plan); Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Float revenue; Account maintenance fees Service code 21 | — | $57K |
| STANDISH MELLON ASSET MANAGEMENT CO EIN 25-1890416 INVESTMENT MANAGER | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $19K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 PHARMACY BENEFIT MANAGER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Other services; Recordkeeping fees; Participant communication; Claims processing Service code 12 | — | $15K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Accounting (including auditing); Consulting (general) Service code 10 | — | $12K |
| EY EIN 34-6565596 TAX FORM PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $11K |
| WILLIS TOWERS WATSON EIN 26-0775680 RX COLLABORATIVE SPONSOR | Other fees; Other services; Direct payment from the plan Service code 49 | — | $6K |
| AON CONSULTING, INC. EIN 22-2232264 FORM 5500 PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,930 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,930 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 5,168 | $2.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,811 | $443K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,168 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.