| 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 | — | $3K | $3K | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $3K | $3K | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 1.65% |
| IMG5 | 2960 NORTH MERIDAN ST INDIANAPOLIS, IA 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $653 | $653 | 118.73% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | DBA TRION GROUP, MMC COMPANY 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $97 | $0 | $97 | 17.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 43-1420563 EGWP ADMINISTRATION | Participant communication; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Recordkeeping fees; Other fees; Other services; Direct payment from the plan Service code 12 | — | $235K |
| BLACKROCK FINANCIAL MANAGEMENT, INC EIN 13-3806691 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $197K |
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $77K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 PLAN TRUSTEE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Account maintenance fees; Trustee (directed); Other investment fees and expenses; Float revenue; Other fees Service code 21 | — | $60K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATO | Other fees; Float revenue; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Insurance services; Contract Administrator; Claims processing Service code 12 | — | $19K |
| GENERAL DYNAMICS INFORMATION TECHNO EIN 54-1194322 OBIEE COST ALLOCATION | Other fees; Direct payment from the plan; Other services Service code 49 | — | $16K |
| AON CONSULTING, INC. EIN 22-2232264 FORM 5500 PREP & ACTUARI | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $10K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Accounting (including auditing); Consulting (general) Service code 10 | — | $9K |
| EY EIN 34-6565596 TAX FORM PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $7K |
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 | 1,915 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,915 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 4,911 | $1.9M |
| Life insurance(5 contracts) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 650 | $649K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 170 | $203K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,911 | — |
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.