| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT W OWEN3 Filed as: ROBERT E. PETCOVE | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | BLUE CARE NETWORK OF MICHIGAN | $46K | $0 | $46K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | BLUE CARE NETWORK OF MICHIGAN | $0 | $2K | $2K | 0.09% |
| ROBERT W OWEN3 Filed as: ROBERT E. PETCOVE | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $24K | $0 | $24K | 2.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD 3 RADNOR CORPORATE CENTER RADNOR, PA 19087 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $913 | $913 | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 7.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 2.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN, INC. | 755 WEST BIG BEAVER ROAD TROY, MI 48084 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $96 | $0 | $96 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 4.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $878 | $0 | $878 | 2.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.73% |
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 | 543 | 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) | 543 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 242 | $2.5M |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 276 | $134K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 344 | $20K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 543 | $132K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 543 | $132K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 543 | $132K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 242 | $2.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 543 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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.