| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD., FLOOR 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $44K | $3K | $47K | 3.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLAZA, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $136K | — | $136K | 9.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD., 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $18K | $18K | 1.25% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DR. NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $181K | $24K | $205K | 23.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD., 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $2K | $32K | 3.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLAZA, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 0.83% |
| MORRIS, CHRISTOPHER, ROBERT3 | 2977 SIDCO DR. NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $259 | — | $259 | 0.03% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DR. NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $90K | $10K | $99K | 27.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W. GOLF RD., 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $2K | $17K | 4.89% |
| MORRIS, CHRISTOPHER, ROBERT3 | 2977 SIDCO DR. NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD., SUITE 408 BINGHAM FARMS, MI 48025 | EYE MED | $36K | — | $36K | 11.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES,INC. | 30150 TELEGRAPH RD., SUITE 408 BINGHAM FARMS, MI 48025 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $12K | — | $12K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES,INC. | P.O. BOX 3009 ARLINGTON HTS., IL 60006 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $2K | $2K | 1.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES,INC. | P.O. BOX 7007 TROY, MI 480077007 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $54 | $54 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Direct payment from the plan; Float revenue; Contract Administrator; Claims processing; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.7M |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other fees; Other commissions; Non-monetary compensation Service code 22 | 30150 TELEGRAPH RD. SUITE 408 BINGHAM FARMS, MI 48025 | $169K |
| UNUM LIFE ISNURANCE CO. OF AMERICA EIN 01-0278678 NONE | Contract Administrator Service code 13 | — | $90K |
| PLAN SOURCE EIN 55-0800751 NONE | Contract Administrator; Claims processing Service code 12 | — | $63K |
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 | 3,455 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,482 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 5,457 | $1.5M |
| Vision | EYE MED | 4,513 | $312K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,462 | $1.8M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,462 | $1.4M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,462 | $1.4M |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,462 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,457 | — |
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.