| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLE SHUPLE3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $32K | $0 | $32K | 3.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $0 | $914 | $914 | 0.09% |
| COLE SHUPLE3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $22K | $0 | $22K | 3.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.11% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $23 | $23 | 0.02% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER AND ASSOCIATES, LLC | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $842 | $0 | $842 | 10.45% |
| KELLY M TIMMONS4 Filed as: KELLY M. TIMMONS | 56657 SCOTLAND BOULEVARD SHELBY TOWNSHIP, MI 48316 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $152 | $0 | $152 | 1.89% |
| ANTHONY P PETRILL4 Filed as: ANTHONY P. PETRILL | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $46 | $0 | $46 | 0.57% |
| PETRILL AND ASSOCIATES LLC4 Filed as: PETRILL AND ASSOCIATES, LLC | 1613 LOOKOUT CIRCLE WAXHAW, NC 28173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $33 | $0 | $33 | 0.41% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 253 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 253 | $739K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 253 | $739K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 123 | $96K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 123 | $96K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 123 | $96K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 253 | $1.8M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 123 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.