| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT SETTLE3 | 4000 TOWN CENTER DRIVE, STE 8 SOUTHFIELD, MI 480758075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $18K | — | $18K | 1.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SRVCE LLC STOCKTON CON | 2600 W. BIG BEAVER RD. SUITE 1 TROY, MI 480848084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $6K | $6K | 0.60% |
| USI INSURANCE SERVICES LLC3 | 222 S RIVERSIDE PLAZA STE 63 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $9K | $9K | 1.28% |
| USI INSURANCE SERVICES LLC3 | 222 S RIVERSIDE PLAZA STE 63 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.46% |
| BENEFITS SOLUTIONS GROUP LLC3 Filed as: BENEFITS SOLUTIONS GROUP | 2400 WOLF RD STE 100 WESTCHESTER, IL 60154 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | — | $15K | 6.76% |
| LOTTES, DOUGLAS E3 | 1036 CAMDEN DR LANSING, MI 48917 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.74% |
| TITAN BENEFIT COMMUNICATIONS LLC3 | 504 EAST 4TH ST ROYAL OAK, MI 48067 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.48% |
| PIERCE, DWIGHT, L3 Filed as: PIERCE, DWIGHT - BENEFITS TECHNOLOG | 1200 E. TAFT AVENUE SAPULPA, OK 74066 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 N/A | Contract Administrator Service code 13 | — | $22K |
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 | 1,337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,963 | $1.0M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,963 | $1.0M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 660 | $226K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,361 | $978K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,361 | $933K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,963 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.