| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NICHOLAS K KAMAI3 | 30150 TELAGRAPH SUITE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $214K | — | $214K | 4.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 22930 NINE MILE ROAD JOPLIN, MO 64803 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD FLOOR 2 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 1.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES,INC. | TWO PIERCE PLACE 21ST FLOOR ITASCA, IA 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $2K | $28K | 16.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $242 | $11K | 15.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $690 | $690 | 0.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $772 | $4K | 7.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURACE COMPANY OF AMERICA | $6K | $484 | $6K | 16.25% |
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 | 660 | 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) | 660 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 995 | $5.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 11,077 | $400K |
| Vision(2 contracts) | VISION SERVICE PLAN | 624 | $2K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 660 | $136K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 319 | $173K |
| Long-term disability | UNUM LIFE INSURACE COMPANY OF AMERICA | 332 | $39K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 660 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,077 | — |
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.