| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAYMOND S. LUNDSTEN3 | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | BLUE CARE NETWORK OF MICHIGAN | $68K | $0 | $68K | 4.33% |
| RAYMOND S. LUNDSTEN3 | 4000 TOWN CENTER, SUITE 800 SOUTHFIELD, MI 48075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | $0 | $13K | 4.57% |
| ACTION BENEFITS COMPANY | 26533 EVERGREEN ROAD, SUITE 400 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | $0 | $3K | 1.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2975 REGENT BOULEVARD IRVING, TX 75063 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 4.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 6.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203066 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $0 | $884 | $884 | 0.99% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | FSL | $4K | $0 | $4K | 15.00% |
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 | 256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 384 | $1.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 343 | $129K |
| Vision | FSL | 390 | $24K |
| Life insurance | STANDARD INSURANCE COMPANY | 247 | $89K |
| Long-term disability | STANDARD INSURANCE COMPANY | 247 | $89K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 384 | $1.9M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 253 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.