| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH ROAD SUITE 408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $38K | — | $38K | 1.56% |
| ERIC T. HAMMILL3 | 30150 TELEGRAPH ROAD SUITE 408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | — | $28K | 1.17% |
| DANIEL WERNER3 | 2465 WENDRICK COURT WEST BLOOMFIELD, MI 483233664 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | — | $9K | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 480255708 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $4K | $9K | 4.11% |
| DANIEL WERNER3 | 2465 WENDRICK COURT WEST BLOOMFIELD, MI 483233664 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | TWO PIERECE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 8.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2850 W. GOLF ROAD,11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.35% |
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH ROAD SUITE 408 BINGHAM FARMS, MI 480255708 | BLUE CARE NETWORK OF MICHIGAN | $561 | — | $561 | 1.10% |
| DANIEL WERNER3 | 2465 WENDRICK COURT WEST BLOOMFIELD, MI 483233664 | BLUE CARE NETWORK OF MICHIGAN | $169 | — | $169 | 0.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 30150 TELEGRAPH ROAD SUITE 408 BINGHAM FARMS, MI 480254545 | BLUE CARE NETWORK OF MICHIGAN | — | $65 | $65 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | TWO PIERECE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 16.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2850 W. GOLF ROAD,11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $409 | $409 | 1.71% |
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 | 361 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 364 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 537 | $2.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 417 | $209K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 417 | $209K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $114K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $114K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $114K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 537 | $2.5M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.