| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MODI FINANCIAL3 | 21500 HAGGERTY ROAD, SUITE 140 NORTHVILLE, MI 481678902 | METROPOLITAN LIFE INSURANCE COMPANY | $67K | — | $67K | 4.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Contract Administrator Service code 13 | — | $1.0M |
| DELTA DENTAL OF MICHIGAN EIN 38-2179148 NONE | Contract Administrator Service code 13 | — | $61K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator Service code 13 | — | $46K |
| WILLIS TOWERS WATSON US LLC EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $21K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,179 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK | 6 | $99K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN - DELTACARE DMO | 38 | $68K |
| Vision(2 contracts, 2 carriers) | DAVIS VISION | 1,776 | $159K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $1.5M |
| Prescription drug | BLUE CARE NETWORK | 6 | $99K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,179 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,179 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.