| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #741909 ATLANTA, GA 30374 | DELTA DENTAL OF MICHIGAN | $217K | — | $217K | 1.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Other fees; Float revenue; Consulting (general); Claims processing Service code 12 | — | $10.0M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 TPA | Insurance services; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Consulting (general) Service code 12 | — | $1.4M |
| HARTFORD LIFE AND ACCIDENT EIN 06-0838648 TPA | Insurance services; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Claims processing; Consulting (general) Service code 12 | — | $560K |
| SUSANNA RUSSELL, WATSON WYATT & CO. | Other fees; Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $218K |
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 | 19,995 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,831 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 22,826 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 46,430 | $13.2M |
| Vision | VISION SERVICE PLAN | 21,459 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 46,430 | — |
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.