| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | BLUE CARE NETWORK OF MICHIGAN | $24K | — | $24K | 4.81% |
| ACTION BENEFITS COMPANY3 | — | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 0.89% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 4.73% |
| ACTION BENEFITS COMPANY3 | — | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 0.88% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.19% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $585 | — | $585 | 1.09% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 11.88% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $904 | — | $904 | 2.02% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 13.48% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $817 | — | $817 | 2.02% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.95% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $111 | — | $111 | 1.09% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 18.35% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $191 | — | $191 | 1.91% |
| WILSHIRE BENEFITS GROUP INC3 Filed as: WILSHIRE BENEFITS GROUP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $935 | — | $935 | 13.51% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $139 | — | $139 | 2.01% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 109 | $700K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 90 | $53K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 87 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $40K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 109 | $700K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.