| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA HOLLINGSWORTH3 | 111 CONGRESSIONAL BOULEVARD SUITE 100 CARMEL, IN 46032 | BLUE CARE NETWORK OF MICHIGAN | $19K | — | $19K | 1.92% |
| PATRICIA HOLLINGSWORTH3 | 111 CONGRESSIONAL BOULEVARD SUITE 100 CARMEL, IN 46032 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $19K | $2K | $21K | 2.60% |
| K HARRIS & ASSOCIATES, LLC3 Filed as: K. HARRIS & ASSOCIATES | 950 W. NORTON AVE SUITE 201 MUSKEGON, MI 49441 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.19% |
| NASCA & ASSOCIATES3 | 303 WEST ERIE STREET SUITE 400 CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $547 | — | $547 | 1.25% |
| ROBERT J AURIN3 Filed as: ROBERT M. LANE | 303 W. ERIE STREET SUITE 400 CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $541 | — | $541 | 1.23% |
| MIDWEST BENEFIT SOLUTIONS INC.3 | 303 W. ERIE STREET SUITE 400 CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $541 | — | $541 | 1.23% |
| MIKE S GAYNOR3 Filed as: MIKE S. GAYNOR | 625 KENMOOR AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $379 | — | $379 | 0.86% |
| MARK D BARBIER3 Filed as: MARK D. BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | CONTINENTAL AMERICAN INSURANCE COMPANY | $267 | — | $267 | 0.61% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 303 WEST ERIE SUITE 400 CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $195 | — | $195 | 0.44% |
| TODD DEVOSS3 | 321 N. CLARK STREET SUITE 624 CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.11% |
| TREVOR FENNELL3 Filed as: TREVOR R. FENNELL | 133 WEST 22ND STREET NEW YORK, NY 10011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $38 | — | $38 | 0.09% |
| JOSEPH A NASCA3 Filed as: JOSEPH A. NASCA | 28081 MAPLE AVE BARRINGTON, IL 60010 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.04% |
| JACQUELINE CASTRO3 | 1133 N. DEARBORN STREET CHICAGO, IL 60610 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE, LLC | 111 CONGRESSIONAL BOULEVARD CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $681 | $6K | 22.72% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE, LLC | 111 CONGRESSIONAL BOULEVARD CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $208 | $4K | 21.17% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE, LLC | 111 CONGRESSIONAL BOULEVARD SUITE 100 CARMEL, IN 46032 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $362 | $2K | 13.30% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE, LLC | 111 CONGRESSIONAL BOULEVARD CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $129 | $2K | 21.49% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 408 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 408 | $808K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 408 | $808K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 279 | $38K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 30 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 21 | $9K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 408 | $1.8M |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 279 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.