| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN, INC | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | DELTA DENTAL OF MICHIGAN | $10K | — | $10K | 1.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MI INC | 26555 EVERGREEN RD STE 1600 SOUTHFIELD, MI 480764257 | PRUDENTIAL INSURANCE CO OF AMERICA | $58K | $0 | $58K | 11.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | SUITE 100 10151 DEERWOOD PARK BLVD BLDG 100 JACKSONVILLE, FL 32256 | PRUDENTIAL INSURANCE CO OF AMERICA | $3K | $0 | $3K | 0.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE CO OF AMERICA | $2K | $0 | $2K | 0.46% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE CO OF AMERICA | $0 | $234 | $234 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN, INC | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 495045356 | VISION SERVICE PROVIDER | $3K | $0 | $3K | 2.52% |
| HRH MICHIGAN INC3 Filed as: HRH MICHIGAN INC (GR RAPIDS) | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | $80K | $91K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHILED OF MICHIGAN EIN 38-2069753 TPA | Other fees; Float revenue; Claims processing; Contract Administrator; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 12 | — | $451K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $39K |
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 | 677 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 113 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 790 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 613 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 1,388 | $515K |
| Vision | VISION SERVICE PROVIDER | 514 | $106K |
| Life insurance | PRUDENTIAL INSURANCE CO OF AMERICA | 677 | $494K |
| Long-term disability | PRUDENTIAL INSURANCE CO OF AMERICA | 677 | $494K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 613 | $0 |
| Other | PRUDENTIAL INSURANCE CO OF AMERICA | 677 | $494K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,388 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.