| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRENDA K. ARMOUR Filed as: BRENDA K ARMOUR | 30150 TELEGRAPH RD S408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $83K | $93K | 25.98% |
| NAILE PALAJ5 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | $31K | $36K | 10.06% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD S408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $597 | — | $597 | 0.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PL 21ST FL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 12.03% |
| KAPNICK & COMPANY, INC. Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $696 | — | $696 | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PL 21ST FL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 12.86% |
| KAPNICK & COMPANY, INC. Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $546 | — | $546 | 1.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2600 SOUTH TELEGRAPH ROAD BLOOMFIELD HILLS, MI 48302 | EYEMED VISION CARE | $3K | — | $3K | 9.92% |
| KAPNICK & COMPANY, INC. Filed as: KAPNICK INSURANCE GROUP | 769 CHICAGO RD. TROY, MI 48083 | EYEMED VISION CARE | $845 | — | $845 | 3.29% |
| GOODMAN VENEGAS INSURANCE AGENCY | 2800 LIVERNOIS TROY, MI 48083 | EYEMED VISION CARE | $418 | — | $418 | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD S408 BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.88% |
| KAPNICK & COMPANY, INC. Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $847 | — | $847 | 4.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $148 | — | $148 | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD S408 BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $85 | — | $85 | 1.02% |
| KAPNICK & COMPANY, INC. Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $43 | — | $43 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | PO BOX 2888 DETROIT, MI 48231 | $264K |
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 | 385 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 798 | $26K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 402 | $90K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 25 | $51K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 390 | $357K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 402 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 798 | — |
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.