| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX #741909 ATLANTA, GA 30374 | DELTA DENTAL OF MICHIGAN | $120K | — | $120K | 0.99% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | DELTA DENTAL OF MICHIGAN | $35K | — | $35K | 0.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 22-3461740 N/A | Contract Administrator; Other fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Claims processing Service code 12 | — | $29.6M |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 N/A | Insurance services; Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.); Non-monetary compensation; Claims processing; Insurance brokerage commissions and fees; Consulting (general); Direct payment from the plan; Other commissions; Contract Administrator; Float revenue; Other fees Service code 12 | — | $7.8M |
| HARTFORD LIFE AND ACCIDENT EIN 06-0838648 N/A | Contract Administrator; Direct payment from the plan; Consulting (general); Other fees; Claims processing; Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $587K |
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 | 16,662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,191 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 39,229 | $12.1M |
| Vision | VISION SERVICE PLAN | 16,315 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 39,229 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.