| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CARE NETWORK OF MICHIGAN | $51K | $0 | $51K | 4.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CARE NETWORK OF MICHIGAN | $0 | $690 | $690 | 0.06% |
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $0 | $14K | 4.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $165 | $165 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $54 | $54 | 0.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $36 | $36 | 0.04% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER AND ASSOCIATES LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PREPAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $1K | $0 | $1K | 13.90% |
| KELLY M TIMMONS4 Filed as: KELLY M. TIMMONS | PO BOX 21608 COLUMBUS, OH 43221 | PREPAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $142 | $0 | $142 | 1.56% |
| TONYA DEAN PETRILL4 | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PREPAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $109 | $0 | $109 | 1.20% |
| ANTHONY P PETRILL4 Filed as: ANTHONY P. PETRILL | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PREPAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $99 | $0 | $99 | 1.09% |
| CHARLES D. DAHL4 | 1212 ADA STREET OWOSSO, MI 48867 | PREPAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $16 | $0 | $16 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $523 | $0 | $523 | 6.45% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | AFLAC | $466 | $0 | $466 | 5.75% |
| BETH J. SOMMERS3 | 255 MEADOWVIEW DRIVE ATTICA, NY 48412 | AFLAC | $392 | $71 | $463 | 5.71% |
| RICHARD J MOELLER3 Filed as: RICHARD J. MOELLER | 23025 CLAIRWOOD STREET SAINT CLAIR SHORES, MI 48080 | AFLAC | $73 | $8 | $81 | 1.00% |
| SHAUN M KLUG3 Filed as: SHAUN M. KLUG | 46389 SPINNING WHEEL DRIVE CANTON, MI 48187 | AFLAC | $61 | $8 | $69 | 0.85% |
| MJ INSURANCE3 Filed as: MIKE HOOVER AND VARIOUS AGENTS | 206 LAKE STREET ELK RAPIDS, MI 49629 | AFLAC | $17 | $12 | $29 | 0.36% |
| DANIEL MACDONALD3 Filed as: DANIEL E. MACDONALD | 28655 OAKMONTE CIRCLE WEST NEW HUDSON, MI 48165 | AFLAC | $10 | $0 | $10 | 0.12% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 196 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $106K |
| Vision | VISION SERVICE PLAN | 90 | $15K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 107 | $90K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 107 | $90K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 107 | $90K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 196 | $1.4M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 107 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
No prospect flags tripped on this filing.