| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC. | 32255 NORTHWESTERN HWY SUITE 201 FARMINGTON HILLS, MI 48334 | BLUE CARE NETWORK OF MICHIGAN | $34K | — | $34K | 1.55% |
| RUBIN TORREZ3 | 32255 NORTHWESTERN HWY SUITE 201 FARMINGTON, MI 48334 | PRIORITY HEALTH | $12K | — | $12K | 1.94% |
| RAYOND D. DEWEY3 | 333 BRIDGE STREET NW SUITE 710 GRAND RAPIDS, MI 49504 | PRIORITY HEALTH | $6K | — | $6K | 1.03% |
| RAYMOND D DEWEY3 | 333 BRIDGE ST NW SUITE 710 GRAND RAPIDS, MI 49504 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | — | $15K | 3.35% |
| RUBIN TORREZ3 | 32255 NORTHWESTERN S201 FARMINGTON HILLS, MI 48334 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN | 32255 N. WESTERN HWY SUITE 201 FARMINGTON HILLS, MI 48334 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $719 | $719 | 0.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC. | PO BOX 416719 BOSTON, MA 02241 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $7K | $22K | 5.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC. | 32255 NORTHWESTERN HWY SUITE 201 FARMINGTON HILLS, MI 48334 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | — | $48K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC. | ONE TOWN SQUARE SUITE 800 SOUTHFIELD, MI 48086 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC. | 32255 NORTHWESTERN HWY SUITE 201 FARMINGTON HILLS, MI 48334 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 29.96% |
| BENEFIT HARBOR INSURANCE SERVICE3 Filed as: BENEFIT HARBOR INS SVCS LLC | 14785 PRESTON ROAD SUITE 1000 DALLAS, TX 75254 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.48% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS | 648 MONRO NW SUITE 300 GRAND RAPIDS, MI 49503 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $91 | — | $91 | 0.29% |
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 | 492 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 494 | $3.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 707 | $404K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 355 | $102K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 492 | $320K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 492 | $320K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 492 | $320K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 494 | $2.2M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 492 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 707 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.