| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $75K | $0 | $75K | 0.88% |
| USI INSURANCE SERVICES LLC3 | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $4K | $4K | 0.04% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MICHIGAN | $10K | $0 | $10K | 1.68% |
| THE UFER GROUP3 | 2349 EAST STADIUM BOULEVARD ANN ARBOR, MI 48104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 14.41% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 7.33% |
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 | 764 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,329 | $8.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 1,479 | $596K |
| Vision | VISION SERVICE PLAN | 495 | $140K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 784 | $986K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 784 | $986K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 784 | $986K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,329 | $8.5M |
| Other(4 contracts, 4 carriers) | DEARBORN LIFE INSURANCE COMPANY | 784 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,479 | — |
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.