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| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIDELITY INVESTMENTS EIN 04-2647786 | Claims processing Service code 12 | PO BOX 73307 CHICAGO, IL 60673 | $35K |
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 | Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 1 FOUNTAIN SQUARE CHANTTANOOGA, TN 37402 | $33K |
| UNUM INSURANCE COMPANY EIN 04-2381280 | Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions; Insurance agents and brokers Service code 22 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $10K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 | Other commissions; Non-monetary compensation; Other fees; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 4100 OKEMOS RD OKEMOS, MI 48864 | $0 |
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 | 2,183 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,258 | $19.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 4,184 | $1.4M |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 3,511 | $168K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,178 | $707K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,178 | $469K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,258 | $10.6M |
| Other(7 contracts, 5 carriers) | UNUM INSURANCE COMPANY | 2,183 | $826K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,184 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.