| 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 | $33K | $0 | $33K | 3.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $0 | $2K | $2K | 0.16% |
| GARY M. MIKLOSOVIC3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | $0 | $20K | 4.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH, SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $531 | $531 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, IL 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.17% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $21 | $21 | 0.02% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER AND ASSOCIATES LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 10.35% |
| TONYA DEAN PETRILL4 | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $225 | $0 | $225 | 2.05% |
| KELLY M TIMMONS4 Filed as: KELLY M. TIMMONS | PO BOX 21608 COLUMBUS, OH 43221 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $151 | $0 | $151 | 1.38% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 257 | $1.5M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 257 | $422K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 257 | $422K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $98K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $98K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $98K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 257 | $1.5M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 113 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.