| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAYMOND S. LUNDSTEN3 | ONE INTERNATIONAL PLAZA, SUITE 40 PHILADELPHIA, PA 19113 | BLUE CARE NETWORK OF MICHIGAN | $45K | $0 | $45K | 2.72% |
| USI INSURANCE SERVICES LLC3 | 2600 WEST BIG BEAVER ROAD, SUITE 1 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $0 | $1K | $1K | 0.07% |
| RAYMOND S. LUNDSTEN3 | ONE INTERNATIONAL PLAZA, SUITE 40 PHILADELPHIA, PA 19113 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $0 | $14K | 2.79% |
| USI INSURANCE SERVICES LLC3 | 2600 WEST BIG BEAVER ROAD, SUITE 1 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $157 | $157 | 0.03% |
| USI INSURANCE SERVICES LLC3 | 1 HILLCREST DRIVE EAST CHARLESTON, WV 25311 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 4.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $6K | $0 | $6K | 5.22% |
| 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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 347 | $2.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 441 | $127K |
| Vision | FSL | 409 | $24K |
| Life insurance | STANDARD INSURANCE COMPANY | 257 | $107K |
| Long-term disability | STANDARD INSURANCE COMPANY | 257 | $107K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 347 | $2.2M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 257 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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.