| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | DELTA DENTAL OF MICHIGAN | $14K | — | $14K | 10.14% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 6.76% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: 360 RISK MANAGEMENT, INC. | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 15.89% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $722 | — | $722 | 5.64% |
| SHERRY ANN DANCY3 | 150 E MOUNT ST STE 202 COLUMBUS, OH 43125 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $378 | — | $378 | 2.95% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | — | $1K | — | $1K | 15.00% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 13.85% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $361 | — | $361 | 6.11% |
| SHERRY ANN DANCY3 | 150 E MOUNT ST STE 202 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $162 | — | $162 | 2.74% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $259 | — | $259 | 5.16% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $699 | — | $699 | 28.28% |
| SHERRY ANN DANCY3 | 150 E MOUNT ST STE 202 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 2.38% |
| RISHIE T MODI3 | 21500 HAGGERTY RD SUITE 140 NORTHVILLE, MI 48167 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $124 | — | $124 | 27.87% |
| SHERRY ANN DANCY3 | 150 E MOUNT ST STE 202 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $373 | — | $373 | 100.00% |
| SHERRY ANN DANCY3 | 150 E MOUNT ST STE 202 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 1.41% |
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 | 239 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 338 | $139K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 239 | $15K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $103K |
| Short-term disability(8 contracts) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 28 | $25K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $90K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.