| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK C NIXON3 Filed as: MARK E KRAMER | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $31K | — | $31K | 1.41% |
| DEVON J DOBRIN3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MA 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1K | — | $1K | 0.05% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.05% |
| MARK C NIXON3 Filed as: MARK E KRAMER | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $8K | — | $8K | 1.63% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | — | $347 | $347 | 0.07% |
| DEVON J DOBRIN3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $258 | — | $258 | 0.05% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $4K | $11K | 16.69% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $597 | $597 | 0.93% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 7.65% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DRIVE MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 5.37% |
| DIANNA LYNN ATCHISON3 | 15130 SNOWBERRY COURT SPRING LAKE, MI 49456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $77 | $1K | 2.27% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $24 | $1K | 2.06% |
| JASON RODERICK3 | 2130 28TH STREET SOUTHWEST WYOMING, MI 49519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $961 | — | $961 | 1.66% |
| BALLARD FINANCIAL LLC3 | 17441 MADISON STREET SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $559 | $29 | $588 | 1.02% |
| W F HILL AND ASSOCIATES INC3 | 600 WEST LAFAYETTE DETROIT, MI 48226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $323 | $239 | $562 | 0.97% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $327 | $145 | $472 | 0.81% |
| STEVEN R SWEEZEA3 | 9420 WEST PIERSON FLUSHING, MI 48433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $253 | — | $253 | 0.44% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $20 | $91 | 0.16% |
| JEREMY SAMPSEL3 | 3030 SOUTH 9TH STREET KALAMAZOO, MI 49009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $38 | $73 | 0.13% |
| CHARLES ALLEN PINKERTON3 | 2653 CADES COVE BRIGHTON, MI 48114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | $19 | $56 | 0.10% |
| JAMES A KERN3 | 43000 12 OAKS CRESCENT DRIVE NOVI, MI 48377 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $13 | $31 | 0.05% |
| MARK GERALD HAYDEN3 | 12406 LAPEER ROAD DAVISON, MI 48423 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| PARRISH J PEACHEE3 | 109 NORTH UNION STREET WESTFIELD, IN 46074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| DAVID N SOKOL3 Filed as: DAVID NEIL SOKOL | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | NORTHWESTERN MUTUAL | $2K | $505 | $2K | 5.73% |
| IVAN MATTHEW PERUSKI3 | 5444 STATE STREET SAGINAW, MI 48603 | NORTHWESTERN MUTUAL | $904 | $252 | $1K | 2.86% |
| MARK E HARDY3 | 5444 STATE STREET SAGINAW, MI 48603 | NORTHWESTERN MUTUAL | $904 | $252 | $1K | 2.86% |
| SEITZINGER FNCL GP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | NORTHWESTERN MUTUAL | $670 | $80 | $750 | 1.86% |
| GARY J MESSING3 | 114 EAST BROADWAY STREET MT PLEASANT, MI 48858 | NORTHWESTERN MUTUAL | $301 | $108 | $409 | 1.01% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC. | 901 WILSHIRE DRIVE #330 TROY, MI 48084 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 9.95% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 18.30% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $262 | $262 | 0.98% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 16.46% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $201 | $201 | 1.08% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $7K | $8K | 55.82% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 16.06% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $11K | $11K | — |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $725 | $725 | — |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH ROAD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $121 | $121 | — |
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 | 274 | 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) | 274 | 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 | 412 | $2.7M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $14K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 671 | $29K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $83K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 271 | $0 |
| Long-term disability(2 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 57 | $67K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 671 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.