| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN D DAWSON3 | 400 N. EXECUTIVE DR., SUITE 300 BROOKFIELD, WI 53005 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $37K | — | $37K | 1.77% |
| THOMAS MCGRAW3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 0.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | P.O. BOX 1650 MILWAUKEE, WA 532011650 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $398 | $398 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $152 | $152 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | DELTA DENTAL OF MICHIGAN | $11K | — | $11K | 4.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 400 N. EXECUTIVE DRIVE BROOKFIELD, WI 53005 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 1.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 5.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $423 | $6K | 4.98% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $147 | $2K | 4.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 400 N EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | $6K | $8K | 27.46% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 6.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $640 | $29 | $669 | 5.24% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $636 | — | $636 | 4.98% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $237 | — | $237 | 5.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 606731930 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $166 | $16 | $182 | 4.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 200 LIBERTY STREET NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $799 | — | $799 | 20.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $246 | — | $246 | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 3331 W. BIG BEAVER RD., STE 200 TROY, MI 48084 | FEDERAL INSURANCE COMPANY | $349 | — | $349 | 19.99% |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 438 | $2.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 476 | $227K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 449 | $29K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 154 | $129K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 184 | $36K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 184 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.