| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD FL 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $16K | — | $16K | 10.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD FL 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | — | $152 | $152 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020003 | THE LINCOLN NATIONAL INSURANCE COMPANY - LTD | $6K | — | $6K | 17.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL INSURANCE COMPANY - LTD | — | $1K | $1K | 2.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020003 | THE LINCOLN NATIONAL INSURANCE COMPANY - LIFE/AD&D | $5K | — | $5K | 17.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P.O BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL INSURANCE COMPANY - LIFE/AD&D | — | $778 | $778 | 2.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | — | $2K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020003 | THE LINCOLN NATIONAL INSURANCE COMPANY - WEEKLY INCOME | $4K | — | $4K | 17.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | THE LINCOLN NATIONAL INSURANCE COMPANY - WEEKLY INCOME | — | $630 | $630 | 2.96% |
| LAU & LAU ASSOCIATES LLC | 41000 WOODWARD AVE STE 250 E BLOOMFIELD HILLS, MI 48304 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD FL 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $947 | — | $947 | 7.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD FL 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | — | $26 | $26 | 0.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD, STE 408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | $37K | $63K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Consulting (general); Insurance services; Float revenue; Other fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 4520 LINDEN CREEK PKWY FLINT, MI 48507 | $223K |
| GALLAGHER BENEFITS SERVICES EIN 36-4291971 AGENT | Insurance brokerage commissions and fees; Other commissions; Other fees; Non-monetary compensation; Insurance agents and brokers Service code 22 | 2600 S. TELEGRAPH STE 100 BLOOMFIELD HILLS, MI 483020003 | $99K |
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 | 313 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 562 | $0 |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 411 | $172K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 397 | $24K |
| Life insurance | THE LINCOLN NATIONAL INSURANCE COMPANY - LIFE/AD&D | 302 | $27K |
| Short-term disability | THE LINCOLN NATIONAL INSURANCE COMPANY - WEEKLY INCOME | 302 | $21K |
| Long-term disability | THE LINCOLN NATIONAL INSURANCE COMPANY - LTD | 302 | $36K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL INSURANCE COMPANY - LIFE/AD&D | 302 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 562 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.