| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA BOURDAGE3 Filed as: LISA J CHORAZYCZEWSKI | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $23K | — | $23K | 3.72% |
| LISA BOURDAGE3 Filed as: LISA J CHORAZYCZEWSKI | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 3.48% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $5K | 9.60% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $453 | $453 | 0.84% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.32% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $918 | $918 | 2.81% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $285 | $285 | 0.87% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $907 | $3K | 20.32% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $456 | $456 | 2.68% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $138 | $138 | 0.81% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 26.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $154 | $154 | 0.92% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $852 | $537 | $1K | 14.32% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $82 | $82 | 0.85% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 139 | $685K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $54K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $17K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 139 | $685K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.