| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVE PISHA3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | — | $20K | 1.71% |
| DAVE PISHA3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | BLUE CARE NETWORK OF MICHIGAN | $12K | — | $12K | 1.77% |
| LEGACY PARTNERS II LLC3 | 31300 PLYMOUTH RD LIVONIA, MI 48150 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 4.69% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $460 | $460 | 0.84% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $240 | $240 | 0.83% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | VISION SERVICE PLAN | $1K | — | $1K | 5.09% |
| LEGACY PARTNERS II LLC3 | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $188 | $188 | 0.98% |
| LEGACY PARTNERS II LLC3 Filed as: LEGACY PARTNERS II, LLC | 33304 GRAND RIVER AVE FARMINGTON, MI 48336 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $160 | $160 | 0.95% |
| LEGACY PARTNERS II LLC3 | 31300 PLYMOUTH RD LIVONIA, MI 48150 | DELTA DENTAL OF MICHIGAN | $355 | — | $355 | 4.84% |
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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 176 | $680K |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 313 | $148K |
| Vision | VISION SERVICE PLAN | 140 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $55K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $29K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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.