| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MICHIGAN INC | 32255 NORTHWESTERN HWY STE 201 FARMINGTON HILLS, MI 483341532 | PRINCIPAL LIFE INSURANCE COMPANY | $99K | — | $99K | 9.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | PO BOX 3727 NORFOLK, VA 235143727 | PRINCIPAL LIFE INSURANCE COMPANY | $37K | — | $37K | 3.56% |
| RAYMOND D DEWEY3 | 333 BRIDGE ST NW STE 710 GRAND RAPIDS, MI 49504 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | $37K | $57K | 15.08% |
| BART CASEY3 | 500 1ST ST SE CEDAR RAPIDS, IA 52401 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | $37K | $49K | 13.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MI EIN 38-2069753 TPA | Contract Administrator; Direct payment from the plan; Other fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Claims processing Service code 12 | — | $638K |
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 | 862 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 862 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 862 | $377K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 2,839 | $1.0M |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 2,839 | $1.0M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 2,839 | $1.0M |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 2,839 | $1.0M |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 2,839 | $1.0M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 862 | $377K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,839 | — |
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.