| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | SELECTHEALTH | $97K | — | $97K | 0.93% |
| 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 | $159K | — | $159K | 1.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | DELTA DENTAL OF MICHIGAN | $36K | — | $36K | 2.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNUM INSURANCE COMPANY | $37K | — | $37K | 15.00% |
| BSC AGENCY LLC3 Filed as: BSC AGENCY, LLC | 1025 ASHWORTH RD SUITE 101 WEST DES MOINES, IA 50265 | UNUM INSURANCE COMPANY | $7K | — | $7K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNUM INSURANCE COMPANY | $33K | — | $33K | 16.16% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD SUITE 100 WEST DES MOINES, IA 50265 | UNUM INSURANCE COMPANY | $7K | — | $7K | 3.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | NATIONAL VISION ADMINISTRATORS | $5K | — | $5K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | UNUM INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $484 | — | $484 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIDELITY INVESTMENTS EIN 04-2647786 | Claims processing Service code 12 | PO BOX 73307 CHICAGO, IL 60673 | $34K |
| 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 CHATTANOOGA, TN 37402 | $27K |
| UNUM INSURANCE COMPANY EIN 04-2381280 | Non-monetary compensation; Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | $8K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 | Other commissions; Insurance brokerage commissions and fees; Non-monetary compensation; Other fees; Insurance agents and brokers 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 | 2,164 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SELECTHEALTH | 2,174 | $19.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 4,086 | $1.3M |
| Vision | NATIONAL VISION ADMINISTRATORS | 3,443 | $166K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,162 | $578K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,162 | $362K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,174 | $9.0M |
| Other(7 contracts, 5 carriers) | UNUM INSURANCE COMPANY | 2,164 | $691K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,086 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.