| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE - 21ST FL ITASCA, IL 60143 | HEALTH ALLIANCE PLAN | $372K | — | $372K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FL ITASCA, IL 60143 | HEALTH ALLIANCE PLAN | $136K | — | $136K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE FL 14 ITASCA, IL 60143 | DELTA DENTAL OF MICHIGAN | $51K | — | $51K | 2.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE ITASCA, IL 60143 | NGL | $22K | — | $22K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3697 MT. DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | THE GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 14.66% |
| LUCIDO MORRIS ASSOCIATES, LLC3 Filed as: LUCIDO MORRIS ASSOCIATES LLC | 24255 W 13 MILE ROAD SUITE 250 BINGHAM FARMS, MI 48025 | THE GUARDIAN LIFE INSURANCE COMPANY | $101 | — | $101 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE - 14TH FL ITASCA, IL 60143 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 6.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ARTHUR J. GALLAGHER & CO. NOT RELATED | Insurance brokerage commissions and fees Service code 53 | 301 TELEGRAPH RD STE 408 FRANKLIN, MI 48025 | $357K |
| NEXT GENERATION ENROLLMENT NOT RELATED | Contract Administrator Service code 13 | 455 PETIS AVE ADA, MA 49301 | $180K |
| GOODLANDER, SWETT & RYBICKI NOT RELATED | Accounting (including auditing) Service code 10 | 4462 PLAINFIELD NE GRAND RAPIDS, ME 49525 | $6K |
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 | 1,982 | 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) | 1,982 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 5,689 | $1.7M |
| Vision(2 contracts, 2 carriers) | NGL | 5,240 | $245K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 325 | $55K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 325 | $55K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY | 325 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,689 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.