| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES (BF) | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $145K | — | $145K | 1.36% |
| ELAINE C. COFFMAN3 Filed as: ELAINE COFFMAN | 325 N OLD WOODWARD AVE STE 370 BIRMINGHAM, MI 48009 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | — | $13K | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVCIES, INC | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | SELECTHEALTH | $86K | — | $86K | 0.96% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | C/O BANK OF AMERICA PO BOX 741738 ATLANTA, GA 303741738 | SELECTHEALTH | $12K | — | $12K | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD GBS FINACE 0 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $54K | — | $54K | 3.77% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $36K | — | $36K | 14.01% |
| BSC AGENCY LLC3 Filed as: BSC AGENCY, LLC | 1025 ASHWORTH RD STE 101 WEST DES MOINES, IA 50265 | UNUM INSURANCE COMPANY | $8K | — | $8K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $32K | — | $32K | 12.55% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC - MICHIGAN | 325 N OLD WOODWARD AVE STE 370 BIRMINGHAM, MI 48009 | UNUM INSURANCE COMPANY | $6K | — | $6K | 2.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | NATIONAL VISION ADMINISTRATORS, LLC | $4K | — | $4K | 2.50% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 444 W 47TH STREET STE 900 KANSAS CITY, MO 64112 | NATIONAL VISION ADMINISTRATORS, LLC | $841 | — | $841 | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $18K | — | $18K | 14.41% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC - MICHIGAN | 325 N OLD WOODWARD AVE STE 370 BIRMINGHAM, MI 48009 | UNUM INSURANCE COMPANY | $718 | — | $718 | 0.59% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $382 | — | $382 | 14.99% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $14 | $14 | 0.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIDELITY INVESTMENTS EIN 04-2647786 | Claims processing Service code 12 | PO BOX 73307 CHICAGO, IL 60673 | $35K |
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 | Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 1 FOUNTAIN SQUARE CHANTTANOOGA, TN 37402 | $33K |
| UNUM INSURANCE COMPANY EIN 04-2381280 | Non-monetary compensation; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $10K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 | Other fees; Other commissions; Non-monetary compensation; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 4100 OKEMOS RD OKEMOS, MI 48864 | $0 |
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 | 2,183 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,183 | 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 | 2,258 | $19.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 4,184 | $1.4M |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 3,511 | $168K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,178 | $707K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,178 | $469K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,258 | $10.6M |
| Other(7 contracts, 5 carriers) | UNUM INSURANCE COMPANY | 2,183 | $826K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,184 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.