| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | RAYMOND D DEWEY 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CARE NETWORK OF MICHIGAN | $34K | — | $34K | 1.12% |
| HRH MICHIGAN INC3 | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CARE NETWORK OF MICHIGAN | — | $5K | $5K | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | RAYMOND D DEWEY 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | — | $11K | 1.47% |
| HRH MICHIGAN INC3 | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $759 | $759 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | RAYMOND DEWEY 330 W COLLEGE AVE APPLETON, WI 54911 | DELTA DENTAL OF MICHIGAN | $12K | — | $12K | 2.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN, INC. | RAYMOND DEWEY PO BOX 416719 BOSOTN, MA 02241 | DELTA DENTAL OF MICHIGAN | $4K | $447 | $5K | 1.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 26555 EVERGREEN ROAD SUITE 1600 SOUTHFIELD, MI 48076 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $47K | $3K | $50K | 14.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC | 3196 KRAFT AVE SE GRAND RAPIDS, MI 49512 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 0.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC | 333 N BRIDGE NW SUITE 710 GRAND RAPIDS, MI 49504 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $423 | — | $423 | 0.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | BANK OF AMERICA PO BOX 416719 BOSTON, MA 02241 | NGL | $6K | — | $6K | 9.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN, INC. | 26555 EVERGREEN SUITE 1600 SOUTHFIELD, MI 48076 | NGL | $529 | — | $529 | 0.83% |
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 | 667 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 719 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 0 | $3.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 867 | $404K |
| Vision | NGL | 418 | $64K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 667 | $336K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 667 | $336K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 667 | $336K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 0 | $3.8M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 667 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 867 | — |
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.