| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KIMBERLY PERKINS3 | 2600 SOUTH TELEGRAPH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $46K | — | $46K | 2.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS | 2600 SOUTH TELEGRAPH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.78% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $754 | $754 | 1.82% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $345 | — | $345 | 0.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 12.46% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $531 | — | $531 | 2.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC NATI | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $425 | $425 | 2.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.31% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $701 | $701 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $253 | $253 | 1.81% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $237 | — | $237 | 1.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 12.12% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $461 | $461 | 5.00% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $265 | — | $265 | 2.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $151 | $151 | 1.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $708 | — | $708 | 8.63% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $410 | $410 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $139 | $139 | 1.69% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $113 | — | $113 | 1.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $653 | — | $653 | 8.38% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $390 | $390 | 5.00% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $127 | — | $127 | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC NATI | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $125 | $125 | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $518 | — | $518 | 13.43% |
| BENEFIT PROFILES INC3 | 500 CASCADE WEST PARKWAY SOUTHEAST SUITE 160 GRAND RAPIDS, MI 46546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $193 | $193 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $110 | $110 | 2.85% |
| GRAND RISK ADVISORS LLC3 | 910 12TH STREET NORTHWEST GRAND RAPIDS, MI 49504 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $60 | — | $60 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $212 | $212 | — |
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 | 237 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 260 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 260 | $1.6M |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $41K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $13K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 260 | $1.6M |
| Other(6 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.