| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 8.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 8.49% |
| MICHAEL G. GREEN3 Filed as: MICHAEL KOPKA | 2600 TELEGRAPH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 38.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S TELEGRAPH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 16.30% |
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $746 | — | $746 | 3.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2600 TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 14.72% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 332 | $22K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 314 | $168K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 295 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 74 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.