| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | $29K | — | $29K | 2.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.20% |
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $11K | — | $11K | 3.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 11.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $551 | $551 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES DBA CBA | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $991 | — | $991 | 5.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $571 | — | $571 | 3.34% |
| GRIFFIN, STEVEN, RAY3 | 2200 MORRIS AVE STE1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $341 | — | $341 | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 68008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $117 | $117 | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $194 | $194 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES DBA CBA | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $628 | — | $628 | 7.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $355 | — | $355 | 4.41% |
| GRIFFIN, STEVEN, RAY3 | 2200 MORRIS AVE STE1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 68008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $135 | $135 | 1.68% |
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 | 267 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 267 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 267 | $303K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 267 | $303K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 188 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 188 | $44K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 267 | $1.3M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 111 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.