| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAN R STAGE3 Filed as: JAN R KRONENBURG | 711 EISENHOWER DR KIMBERLY, WI 54136 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $39K | — | $39K | 1.10% |
| USI INSURANCE SERVICES LLC3 | 2600 W. BIG BEAVER RD. SUITE 140 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.07% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 2.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 HILLCREST DR E CHARLESTON, WV 25311 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 0.72% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $15K | $15K | 7.23% |
| USI INSURANCE SERVICES LLC3 | 300 KANAWHA BLVD EAST SUITE 310, 3RD FLOOR CHARLESTON, WV 25301 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 1.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2400 E COMMERCIAL BLVD FT LAUDERDALE, FL 33308 | STANDARD INSURANCE COMPANY | — | $932 | $932 | 0.46% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $8K | $8K | 6.24% |
| USI INSURANCE SERVICES LLC3 | 300 KANAWHA BLVD EAST SUITE 310, 3RD FLOOR CHARLESTON, WV 25301 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 2.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2400 E COMMERCIAL BLVD FT LAUDERDALE, FL 33308 | STANDARD INSURANCE COMPANY | — | $592 | $592 | 0.47% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $5K | $5K | 6.45% |
| USI INSURANCE SERVICES LLC3 | 300 KANAWHA BLVD EAST SUITE 310, 3RD FLOOR CHARLESTON, WV 25301 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 4.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2400 E COMMERCIAL BLVD FT LAUDERDALE, FL 33308 | STANDARD INSURANCE COMPANY | — | $558 | $558 | 0.74% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 3.88% |
| USI INSURANCE SERVICES LLC3 | 300 KANAWHA BLVD EAST SUITE 310, 3RD FLOOR CHARLESTON, WV 25301 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 3.61% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2400 E COMMERCIAL BLVD FT LAUDERDALE, FL 33308 | STANDARD INSURANCE COMPANY | — | $230 | $230 | 0.48% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 300 KANAWHA BLVD EAST SUITE 310, 3RD FLOOR CHARLESTON, WV 25301 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 21.55% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $578 | $578 | 2.77% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 558 | $3.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 874 | $253K |
| Vision | STANDARD INSURANCE COMPANY | 387 | $48K |
| Life insurance | STANDARD INSURANCE COMPANY | 741 | $125K |
| Short-term disability | STANDARD INSURANCE COMPANY | 543 | $201K |
| Long-term disability | STANDARD INSURANCE COMPANY | 214 | $76K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 558 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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."
No prospect flags tripped on this filing.