| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: SHELBY DIANE BROWN | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | $191K | $203K | 21.02% |
| CHRISTOPHER GRAHAM ERVASTI3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $24K | — | $24K | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $17K | $17K | 1.75% |
| JAY R SCHREIBMAN3 Filed as: JAY SCHREIBMAN | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $28K | — | $28K | 4.53% |
| CHRISTOPHER GRAHAM ERVASTI3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $9K | — | $9K | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $3K | — | $3K | 2.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 300 CENTERVILLE ROAD, SUITE 100 EAST WARWICK, RI 02886 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $32K | — | $32K | 31.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE, SUITE 300 MT LAUREL, NJ 08054 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 7.54% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $234 | $234 | 0.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MICHIGAN INC | 111 S LEROY STREET, SUITE 205 FENTON, MI 48430 | METROPOLITAN LIFE INSURANCE COMPANY | $26 | — | $26 | 1.25% |
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 | 1,274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 1,695 | $624K |
| Vision | VISION SERVICE PLAN | 635 | $150K |
| Life insurance(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,243 | $225K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,243 | $315K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 924 | $968K |
| Other(3 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,243 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,695 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.