| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH, SUITE 408 BINGHAM FARMS, MI 48025 | BLUECROSS BLUESHIELD OF MICHIGAN | $28K | $2K | $30K | 5.61% |
| ACTION BENEFITS COMPANY3 | 24600 NORTHWESTERN SOUTHFIELD, MI 48075 | BLUECROSS BLUESHIELD OF MICHIGAN | $863 | $0 | $863 | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 5.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 21.14% |
| LYNDA B MACDONALD3 Filed as: LYNDA MACDONALD | 28655 OAKMONTE CIRCLE WEST NEW HUDSON, MI 48165 | AFLAC | $2K | $0 | $2K | 11.14% |
| JENNIFER JACKSON3 | 29835 WARWICK COURT NOVI, MI 48377 | AFLAC | $920 | $0 | $920 | 4.11% |
| DANIEL MACDONALD3 | 28655 OAKMONTE CIRCLE WEST NEW HUDSON, MI 48165 | AFLAC | $744 | $0 | $744 | 3.33% |
| KIMBERLEY M MCNULTY3 Filed as: KIMBERLEY MCNULTY | 22452 LAKECREST STREET SAINT CLAIR SHORES, MI 48081 | AFLAC | $462 | $0 | $462 | 2.07% |
| PATTERSON BRYANT GROUP INC3 Filed as: PATTERSON-BRYANT, INC. | 30600 TELEGRAPH ROAD, SUITE 2250 BINGHAM FARMS, MI 48025 | AFLAC | $250 | $0 | $250 | 1.12% |
| MJ INSURANCE3 Filed as: KRAIG SEXTON AND VARIOUS AGENTS | 9864 EAST GRAND RIVER AVENUE SUITE 110 BRIGHTON, MI 48116 | AFLAC | $243 | $0 | $243 | 1.09% |
| YUKO FUJITA3 | 44799 YORKSHIRE DRIVE NOVI, MI 48375 | AFLAC | $232 | $0 | $232 | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | VISION SERVICE PLAN | $610 | $0 | $610 | 8.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | DELTA DENTAL OF MICHIGAN | $335 | $0 | $335 | 5.54% |
No Schedule C service providers reported on this filing.
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF MICHIGAN | 118 | $535K |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 94 | $42K |
| Vision | VISION SERVICE PLAN | 72 | $7K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $24K |
| Short-term disability | AFLAC | 19 | $22K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $24K |
| Prescription drug | BLUECROSS BLUESHIELD OF MICHIGAN | 118 | $535K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 124 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.