| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | KELLEY DEMIRYAN 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $4K | $4K | $8K | 4.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | KIMBERLY KNUE 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $957 | — | $957 | 0.49% |
| KELLEY A. DEMIRYAN3 | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | $15K | $22K | 11.66% |
| KIMBERLY ANN KNUE3 | 30150 TELEGRAPH RD. STE. 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 1.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 30150 TELEGRAPH RD STE 408 BINGHAM FARMS, MI 48025 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $271 | $271 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 30150 TELEGRAPH RD. STE 408 BINGHAM FARMS, MI 48025 | SYMETRA LIFE INSURANCE COMPANY | $12K | — | $12K | 10.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD. 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.62% |
| STRATEGIC ENROLLMENT SERVICES INC.3 | 27064 OAKMEAD DR. PERRYSBURG, OH 435512657 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $27 | $14K | 37.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2600 S. TELEGRAPH RD. STE 100 BLOOMFIELD HILLS, MI 483020968 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $54 | $6K | 16.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P O BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $116 | $116 | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P O BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| STRATEGIC ENROLLMENT SERVICES INC.3 Filed as: STRATEGIC ENROLLMENT SERVICES | 27064 OAKMEAD DR. PERRYSBURG, OH 435512657 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $27 | $9K | 30.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2600 S TELEGRAPH RD. STE. 100 BLOOMFIELD HILLS, MI 483020968 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $54 | $4K | 13.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P O BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $73 | $73 | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P O BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $966 | — | $966 | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES OF | MICHIGAN, INC. 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 600084036 | VISION SERVICE PLAN | $254 | — | $254 | 0.92% |
| STRATEGIC ENROLLMENT SERVICES INC.3 | 27064 OAKMEAD DR PERRYSBURG, OH 435512657 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $27 | $11K | 55.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2600 S. TELEGRAPH RD. STE 100 BLOOMFIELD HILLS, MI 483020968 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $54 | $4K | 18.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P O BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $91 | $91 | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other fees; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $101K |
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 | 342 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 394 | $87K |
| Dental | DELTA DENTAL OF MICHIGAN | 734 | $196K |
| Vision | VISION SERVICE PLAN | 330 | $28K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 281 | $113K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 281 | $113K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 281 | $113K |
| Prescription drug | RXBENEFITS, INC. | 331 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 109 | $188K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 281 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 734 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.