| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC7 | 21250 HAWTHORNE BLVD STE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 6.96% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $3K | $4K | 3.68% |
| USI INSURANCE SERVICES LLC7 | 21250 HAWTHORNE BLVD SUITE 380 TORRENCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $571 | $813 | $1K | 3.64% |
| DESIREE O DONAHUE3 | ONE INTERNATIONAL PLAZA SUITE 40 PHILADELPHIA, PA 19113 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 22.67% |
| JAY R SCHREIBMAN3 | 2600 S TELEGRPAH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 11.27% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DRIVE SUITE 400 VALHALLA, NY 10595 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 6.45% |
| USI INSURANCE SERVICES LLC7 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD STE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.93% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $227 | $304 | $531 | 3.62% |
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 | 236 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 393 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 271 | $120K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 236 | $15K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 70 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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.