| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARY BETH BULLEN3 | 30150 TELEGRAPH RD, STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $55K | — | $55K | 1.97% |
| LEONARD A. BRUCATO3 Filed as: LEONARD BRUCATO | 30150 TELEGRAPH RD, STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 30150 TELEGRAPH RD, STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 30150 TELEGRAPH RD, STE 408 BINGHAM FARMS, MI 48025 | SUN LIFE AND HEALTH INSURANCE CO | $10K | — | $10K | 9.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PLACE, 14TH FL ITASCA, IL 60143 | SUN LIFE ASSURANCE CO OF CANADA | $2K | — | $2K | 8.75% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 596 | $2.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 596 | $2.8M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 596 | $2.8M |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE CO | 268 | $131K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE CO | 268 | $131K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE AND HEALTH INSURANCE CO | 268 | $131K |
| Other(3 contracts, 3 carriers) | SUN LIFE AND HEALTH INSURANCE CO | 302 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 596 | — |
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.