| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | $20K | $0 | $20K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | $0 | $2K | $2K | 0.21% |
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | $0 | $3K | 4.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $763 | $763 | 1.44% |
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 137 | $726K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 150 | $53K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 150 | $53K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 137 | $726K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.