| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC J LASCESKI Filed as: MARC S BYRNES | 1100 SUPERIOR AVE., STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $55K | $70K | 15.04% |
| STEVEN J HOPP | 3 SUMMIT PARK DR., STE 530 INDEPENDENCE, OH 44131 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | $21K | $25K | 5.40% |
| THE JAMES B OSWALD COMPANY Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE E CLEVELAND, OH 44114 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 0.63% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $6K | — | $6K | 10.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE. E, STE 1601 CLEVELAND, OH 441142522 | UNITED OF OMAHA LIFE INSURANCE CO | $1K | $1K | $2K | 3.62% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 9.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE. E, STE 1601 CLEVELAND, OH 441142522 | UNITED OF OMAHA LIFE INSURANCE CO | $1K | $1K | $2K | 4.75% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 8.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE. E, STE 1601 CLEVELAND, OH 441142522 | UNITED OF OMAHA LIFE INSURANCE CO | $556 | $644 | $1K | 2.78% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B OSWALD CO | 1100 SUPERIOR AVE. E, STE 1500 CLEVELAND, OH 441142544 | UNITED OF OMAHA LIFE INSURANCE CO | $742 | — | $742 | 10.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE. E, STE 1601 CLEVELAND, OH 441142522 | UNITED OF OMAHA LIFE INSURANCE CO | $142 | $140 | $282 | 3.83% |
| JAMES A SMAARDYK Filed as: JAMES M. TAYLOR | 3016 SPRING HILL PKWY, SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 1.64% |
| LAURA ANN MARSHALL | 206 THIRD STREET CONCORD, MI 49237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 1.42% |
| CRAIG L SCHROEDER Filed as: CRAIG L. SHROEDER | 7517 W HICKORY RD. HICKORY CORNERS, MI 49060 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 1.34% |
| MARY LOU TAYLOR | 3016 SPRING HILL PKWY, SE SMYRNA, GA 30080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 1.06% |
| DAVID L SMELCER Filed as: DAVID L. SMELCER | PO BOX 279 MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.38% |
| DIANNA LYNN ATCHISON | 15130 SNOWBERRY CT. SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Consulting (general); Float revenue; Insurance services; Non-monetary compensation; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $185K |
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 | 323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 274 | $463K |
| Dental | DELTA DENTAL OF MICHIGAN | 563 | $239K |
| Vision(2 contracts) | SVS VISION MANAGED CARE, INC. | 99 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 319 | $87K |
| Short-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 319 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 319 | $7K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 274 | $463K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 274 | $463K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 13 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 563 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.