| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN | 2600 S. TELEGRAPH RD, SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | $38K | — | $38K | 4.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S. TELEGRAPH RD BLOOMFIELD HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | — | $1K | $1K | 0.14% |
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN | 2600 S. TELEGRAPH RD, SUITE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 4.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S. TELEGRAPH RD BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $469 | $469 | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S. TELEGRAPH RD, SUITE 100 BLOOMFIELD HILLS, MI 483028302 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 S. TELEGRAPH RD BLOOMFIELD HILLS, MI 48302 | METROPOLITAN LIFE INSURANCE COMPANY | $686 | — | $686 | 15.13% |
| MMA SERVICE CORP3 | 620 S CAPITOL AVE LANSING, MI 48933 | METROPOLITAN LIFE INSURANCE COMPANY | — | $227 | $227 | 5.01% |
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 | 98 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 108 | $861K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 125 | $45K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 120 | $11K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 112 | $5K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 108 | $861K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 112 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.