| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL G. GREEN3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $185K | $0 | $185K | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $7K | $7K | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $37K | $12K | $49K | 6.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $63K | $0 | $63K | 9.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 2.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $11K | $11K | 1.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD BLOOMFIELD HILLS, MI 48302 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $8K | $0 | $8K | 5.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 225.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 40.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | FIRST UNUM LIFE INSURANCE COMPANY | $17 | $0 | $17 | 85.00% |
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 | 907 | 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) | 907 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,071 | $11.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 2,047 | $735K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,806 | $141K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,132 | $661K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,132 | $658K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,132 | $658K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,071 | $11.9M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,132 | $658K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,132 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.