| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 312 ELM ST FL 24 CINCINNATI, OH 45202 | DELTA DENTAL PLAN OF MICHIGAN | $18K | — | $18K | 1.70% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS. SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | DELTA DENTAL PLAN OF MICHIGAN | $3K | — | $3K | 0.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 27025 RICHMOND, VA 23261 | METROPOLITAN LIFE INSURANCE COMPANY | $78K | $24 | $78K | 12.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $24K | $24K | 3.86% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST INC | 333 BRIDGE ST NW SUITE 400 GRAND RAPIDS, MI 49504 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 8.00% |
| MEDICAL GROUP INSURANCE SERVICES3 Filed as: MEDICAL GROUP INS. SERVICES, INC. | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $180 | $180 | 0.06% |
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 | 1,594 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,605 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 11 | $0 |
| Dental | DELTA DENTAL PLAN OF MICHIGAN | 3,118 | $1.1M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,698 | $625K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,698 | $951K |
| Prescription drug | PRIORITY HEALTH | 11 | $0 |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 2,698 | $625K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,118 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.