| 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 | $46K | $0 | $46K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CARE NETWORK OF MICHIGAN | $0 | $457 | $457 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 4.13% |
| IMG5 | 2960 NORTH MERIDIAN STREET INIDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $19 | $19 | 0.02% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $3 | $3 | 0.00% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER AND ASSOCIATES, LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 13.93% |
| KELLY M TIMMONS4 Filed as: KELLY M. TIMMONS | PO BOX 21608 COLUMBUS, OH 43221 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $172 | $0 | $172 | 1.50% |
| TONYA DEAN PETRILL4 | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $141 | $0 | $141 | 1.23% |
| ANTHONY P PETRILL4 Filed as: ANTHONY P. PETRILL | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $129 | $0 | $129 | 1.12% |
| CHARLES D. DAHL4 | 1212 ADA STREET OWOSSO, MI 48867 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $21 | $0 | $21 | 0.18% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | AFLAC | $27 | $0 | $27 | 6.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $5 | $0 | $5 | 1.26% |
| BETH SOMMERS3 | 8126 DOWNING STREET WASHINGTON, MI 48094 | AFLAC | $4 | $0 | $4 | 1.01% |
| SHAUN M KLUG3 Filed as: SHAUN KLUG | 46389 SPINNNING WHEEL DRIVE CANTON, MI 48187 | AFLAC | $2 | $0 | $2 | 0.50% |
| DANIEL MACDONALD3 | 28655 OAKMONTE CIRCLE WEST NEW HUDSON, MI 48165 | AFLAC | $1 | $0 | $1 | 0.25% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 189 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 318 | $111K |
| Vision | VISION SERVICE PLAN | 87 | $15K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $90K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $90K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $90K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 189 | $1.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 104 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.