| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $27K | — | $27K | 2.95% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | — | $4K | $4K | 0.44% |
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 5.98% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $133 | $133 | 0.11% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $44 | $2K | 6.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.03% |
| LSG INSURANCE PARTNERS3 | 2600 S TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $627 | $18 | $645 | 5.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $468 | — | $468 | 4.27% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 219 | $1.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 219 | $124K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 219 | $124K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $11K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $25K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 219 | $1.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.