| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A KELLEHER3 Filed as: ROBERT ARTINIAN | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | — | $26K | 2.99% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.12% |
| ROBERT A KELLEHER Filed as: ROBERT ARTINIAN | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $3K | — | $3K | 2.74% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH ROAD STE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | — | $136 | $136 | 0.12% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 5.31% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH RD ERDENHEIM, PA 13038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.73% |
| WILSHIRE BENEFITS GROUP INC5 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $300 | $300 | 0.34% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $859 | $5K | 18.11% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $491 | $491 | 1.78% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $824 | $5K | 18.07% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $471 | $471 | 1.76% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $530 | $3K | 18.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $303 | $303 | 1.80% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $730 | $146 | $876 | 18.01% |
| PATRIOT GROWTH INSURANCE SERVICES | 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $83 | $83 | 1.71% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE STE 330 TROY, MI 48084 | NGL | $1K | — | $1K | 100.00% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 244 | $992K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $89K |
| Vision | NGL | 200 | $1K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $5K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $28K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $27K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.