| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA BOURDAGE3 Filed as: LISA J CHORAZYCZEWSI | 901 WILSHRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $16K | — | $16K | 2.84% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | — | $512 | $512 | 0.09% |
| LISA BOURDAGE3 Filed as: LISA J CHORAZYCZEWSKI | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1K | — | $1K | 2.07% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $22 | $22 | 0.04% |
| 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 | $844 | $3K | 6.58% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $965 | $965 | 1.86% |
| 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 | $985 | $4K | 12.92% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $918 | $918 | 2.93% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $563 | $563 | 1.80% |
| 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 | $570 | $3K | 18.03% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $332 | $332 | 1.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $326 | $326 | 1.73% |
| 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 | $508 | $3K | 18.00% |
| 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 | 5.84% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $290 | $290 | 1.85% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $820 | $301 | $1K | 12.09% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $172 | $172 | 1.86% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 125 | $639K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $52K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $16K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 125 | $639K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
No prospect flags tripped on this filing.