| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 62889 VIRGINIA BEACH, VA 23466 | BLUE CARE NETWORK OF MICHIGAN | $26K | — | $26K | 3.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.25% |
| ADVANTAGE BENEFITS GROUP3 Filed as: ADVANTAGE BENEFITS GROUP INC | 89 MONROE CTR NW STE 200 GRAND RAPIDS, MI 49508 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 8.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 234662889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 234662889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 234662889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $585 | $585 | 4.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 234662889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $609 | $609 | 4.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | GRAND RAPIDS OPCO PO BOX 62889 VIRGINIA BEACH, VA 234662889 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $533 | $533 | 5.53% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 207 | $805K |
| Dental | DELTA DENTAL OF MICHIGAN | 236 | $66K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $26K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 32 | $23K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 207 | $805K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.