| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON | 28411 NORTHWESTERN HWY SUITE 500 SOUTHFIELD, MI 48034 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $86K | $952 | $87K | 1.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 | Insurance agents and brokers; Non-monetary compensation; Other commissions; Insurance brokerage commissions and fees Service code 22 | 600 E. LAFAYETTE BLVD. DETROIT, MI 48226 | $87K |
| FIDELITY INVESTMENTS EIN 04-2647786 | Claims processing Service code 12 | PO BOX 73307 CHICAGO, IL 60673 | $30K |
| DISCOVERY BENEFITS EIN 90-0058554 | Claims processing Service code 12 | 3216 13TH AVE SOUTH PO BOX 9528 FARGO, ND 58106 | $8K |
| CIGNA HEALTHCARE EIN 06-0303370 | Claims processing Service code 12 | 3 SUMMIT PARK DRIVE #250 INDEPENDENCE, OH 44131 | $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 | 813 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 813 | 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 | 813 | $7.1M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 813 | $7.1M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 813 | $7.1M |
| Other | ULLIANCE AND BLOMQUIST-HALE CONSULTING GROUP | 813 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 813 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.