| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEVON J DOBRIN3 | 510 HIGHLAND AVENUE SUITE 295 MILFORD, MI 48381 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $22K | — | $22K | 1.43% |
| DAVID N SOKOL3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 0.30% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MA 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.08% |
| DEVON J DOBRIN3 | 510 HIGHLAND AVENUE SUITE 295 MILFORD, MI 48381 | BLUE CARE NETWORK OF MICHIGAN | $9K | — | $9K | 1.30% |
| DAVID N SOKOL3 | 901 WILSHIRE DRIVE SUITE 330 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 0.31% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | — | $780 | $780 | 0.11% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $4K | $11K | 3.86% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 2.17% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 13.94% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.19% |
| WILSHIRE BENEFITS GROUP INC3 | 901 WILSHIRE DRIVE TROY, MI 48084 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $22 | $4K | 8.00% |
| THOMAS DANIEL SCHMIDT3 | 21608 PINE CONE DRIVE MACOMB, MI 48042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.66% |
| DIANNA LYNN ATCHISON3 | 225 EAST DIVISION ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $743 | — | $743 | 1.52% |
| CYNTHIA SUSANNE EVERY3 | 212 WEST DUNCAN MANCHESTER, MI 48158 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $509 | $5 | $514 | 1.05% |
| JEREMY SAMPSEL3 | 401 HALL STREET SOUTHWEST GRAND RAPIDS, MI 49503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $104 | $202 | 0.41% |
| BALLARD FINANCIAL LLC3 | 17441 MADISON STREET SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.34% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.15% |
| W F HILL AND ASSOCIATES INC3 | 30700 TELEGRAPH ROAD BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.11% |
| DENA ANN MARTHA3 | 225 EAST DIVISION STREET ROCKFORD, MI 49341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| DAVID N SOKOL3 Filed as: DAVID NEIL SOKOL | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | NORTHWESTERN MUTUAL | $2K | $481 | $2K | 5.78% |
| IVAN MATTHEW PERUSKI3 | 5444 STATE STREET SAGINAW, MI 48603 | NORTHWESTERN MUTUAL | $953 | $240 | $1K | 2.89% |
| MARK E HARDY3 | 5444 STATE STREET SAGINAW, MI 48603 | NORTHWESTERN MUTUAL | $953 | $240 | $1K | 2.89% |
| MIRABELLA FNCL GRP LLC3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | NORTHWESTERN MUTUAL | $441 | $53 | $494 | 1.20% |
| GARY J MESSING3 | 114 EAST BROADWAY STREET MT PLEASANT, MI 48858 | NORTHWESTERN MUTUAL | $318 | $114 | $432 | 1.05% |
| DOMINIC ANTHONY MIRABELLA3 | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | NORTHWESTERN MUTUAL | $265 | $32 | $297 | 0.72% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 14.53% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $737 | $737 | 2.14% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC. | 901 WILSHIRE DRIVE #330 TROY, MI 48084 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 11.63% |
| 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 | $818 | $3K | 14.28% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $467 | $467 | 2.44% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | — |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP, INC | 901 WILSHIRE DRIVE SUITE 300 TROY, MI 48084 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $554 | $554 | — |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $317 | $317 | — |
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 | 305 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 321 | 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 | 308 | $2.2M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 251 | $277K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 668 | $32K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 290 | $100K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 290 | $0 |
| Long-term disability(2 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 70 | $76K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 244 | $686K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 290 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 668 | — |
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.