| 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 MICHICAN | $21K | $20K | $42K | 6.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3333 DEPOSIT DRIVE NE SUITE 230 GRAND RAPID, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHICAN | $2K | — | $2K | 0.33% |
| JAN STAGE3 | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 2.97% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $10K | $10K | 4.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 2.54% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.97% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $9K | $9K | 4.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 3.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 6.08% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $5K | $5K | 4.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $804 | — | $804 | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 3.54% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $996 | $996 | 1.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $536 | — | $536 | 1.07% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 19.09% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC | 100 S CREST DR ATLANTA, GA 30281 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 4.62% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $290 | — | $290 | 1.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Claims processing; Consulting (general); Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue; Insurance services Service code 12 | — | $275K |
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 | 385 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 988 | $279K |
| Vision | STANDARD INSURANCE COMPANY | 406 | $50K |
| Life insurance | STANDARD INSURANCE COMPANY | 877 | $200K |
| Short-term disability | STANDARD INSURANCE COMPANY | 877 | $231K |
| Long-term disability | STANDARD INSURANCE COMPANY | 229 | $106K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHICAN | 362 | $619K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 988 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.