| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 W GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | $16K | $42K | 7.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $11K | — | $11K | 4.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $16 | $15K | 17.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.69% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $326 | — | $326 | 0.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD HILLS, MI 48302 | NATIONAL VISION ADMINISTRATORS, LLC | $5K | — | $5K | 10.00% |
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN | 2600 S. TELEGRAPH ROAD STE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $18K | $94K | $112K | — |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: SHELBY BROWN | 2600 S TELEGRAPH RD BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $31K | $37K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $6K | $6K | — |
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 | 800 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 844 | $0 |
| Dental | DELTA DENTAL OF MICHIGAN | 825 | $264K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 754 | $54K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 702 | $577K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 702 | $577K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 702 | $577K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 844 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 844 | $0 |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 702 | $664K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 844 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.