| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BETHANY L. PAGNANI3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $51K | $0 | $51K | 2.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $0 | $25K | 9.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 2.00% |
| AMWINS3 Filed as: AMWINS ANCILLARY, LLC | 1933 STATE ROUTE 35, SUITE 368 WALL, NJ 07719 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $12K | $0 | $12K | 8.02% |
| BETHANY L. PAGNANI3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $2K | $0 | $2K | 3.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | BLUE CARE NETWORK OF MICHIGAN | $0 | $167 | $167 | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | NGL | $1K | — | $1K | 8.00% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | 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 | 248 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 276 | $144K |
| Vision | NGL | 275 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $255K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $255K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $255K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 248 | $1.8M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $259K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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.