| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA SULLIVAN FORLETTA3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $40K | $0 | $40K | 2.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $54 | $13K | 7.63% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $10K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5 | $5 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $10K | $2K | $12K | 11.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | $0 | $2K | 9.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | VISION SERVICE PLAN | $176 | $0 | $176 | 0.81% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 269 | $1.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 289 | $100K |
| Vision | VISION SERVICE PLAN | 131 | $22K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $171K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $171K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $171K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 269 | $1.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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.