| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHILIP A. GABRIELSON3 | 26555 EVERGREEN RD, STE 535 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $27K | $58K | $85K | 11.05% |
| PROADVISOR INSURANCE AGENCY LLC3 | 26555 EVERGREEN RD, STE 535 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $11K | $11K | 1.38% |
| PHILIP A. GABRIELSON3 Filed as: PHILIP A GABRIELSON | 22525 HALL ROAD SUITE B MACOMB, MI 48042 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $44K | — | $44K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Claims processing; Consulting (general); Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Float revenue; Other fees Service code 12 | — | $257K |
| PHILIP A GABREILSON INSURANCE AGENT | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other fees; Other commissions Service code 22 | 22525 HALL RD, STE B MACOMB, MI 48042 | $128K |
| PROADVISOR INSURANCE AGY LLC INSURANCE AGENT | Other fees; Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | 26555 EVERGREEN STE 535 SOUTHFIELD, MI 48076 | $11K |
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 | 400 | 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) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 675 | $765K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 675 | $765K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 675 | $765K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 400 | $292K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 400 | $292K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 400 | $292K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 675 | $765K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 675 | $765K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 400 | $292K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 675 | — |
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.