| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAN R STAGE3 Filed as: JAN R KRONENBURG | 2600 W. BIG BEAVER RD. SUITE 140 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHICAN | $20K | — | $20K | 3.50% |
| JAN STAGE3 | 100 SUMMIT LAKE DR SUITE 400 VALHALLA, NY 10595 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 2.27% |
| JAN R STAGE3 | 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 Filed as: USI INSURANCE SERVICES, LLC | 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 Filed as: USI INSURANCE SERVICES, LLC | 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 Filed as: USI INSURANCE SERVICES, LLC | 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 Filed as: USI INSURANCE SERVICES, LLC | 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% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Consulting (general); Insurance services; Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $256K |
| JAN R KRONENBURG INS AGENTS | Other fees; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 2600 W. BIG BEAVER RD. SUITE 140 TROY, MI 48084 | $20K |
| USI INS SRVCE LLC STOCKTON INS AGENTS | Insurance brokerage commissions and fees; Other fees; Insurance agents and brokers; Non-monetary compensation; Other commissions Service code 22 | 2600 W. BIG BEAVER RD. SUITE 140 TROY, MI 48084 | $4K |
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 | 435 | 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) | 439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| 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 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHICAN | 655 | $562K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.