| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY M. MIKLOSOVIC3 Filed as: GARY M MIKLOSOVIC | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $74K | $0 | $74K | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS (BF) | 2600 S TELEGRAPH STE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CARE NETWORK OF MICHIGAN | $0 | $5K | $5K | 0.10% |
| GARY M. MIKLOSOVIC3 Filed as: GARY M MIKLOSOVIC | 2600 S. TELEGRAPH RD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $0 | $15K | 1.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS (BF) | 2600 S TELEGRAPH STE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $0 | $25K | 12.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STARMOUNT LIFE INSURANCE COMPANY | $8K | $0 | $8K | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $886 | $886 | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $424 | $424 | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $385 | $385 | 1.63% |
| CAMBRIDGE CONSULTING GROUP LLC3 | 400 W 4TH ST STE 300 ROYAL OAK, MI 48067 | UNUM INSURANCE COMPANY | $2K | $188 | $2K | 8.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $2K | $0 | $2K | 7.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SRVCS INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $246 | $246 | 1.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN GENERAL INSURANCE COMPANY | $614 | $305 | $919 | 16.32% |
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 | 1,124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 952 | $6.0M |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 616 | $67K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,124 | $79K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 78 | $197K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 78 | $197K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 952 | $6.0M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,124 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,124 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.