| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHRIEBMAN | 2600 S. TELEGRAPH RD, STE 100 BLOOMFILED HILLS, MI 483028302 | BLUE CARE NETWORK OF MICHIGAN | $10K | — | $10K | 1.58% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | BLUE CARE NETWORK OF MICHIGAN | — | $800 | $800 | 0.13% |
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHRIEBMAN | 2600 S. TELEGRAPH RD. STE 100 BLOOMFIELD HILLS, MI 483028302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 1.45% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD. STE 100 BLOOMFIELD HILLS, MI 483020968 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $154 | $154 | 0.08% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 48302 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 2.42% |
| APEX FINANCIAL SERVICES3 | 27950 ORCHARD LAKE RD. FARMINGTON HILLS, MI 48334 | DELTA DENTAL OF MICHIGAN | $92 | — | $92 | 0.12% |
| LSG INSURANCE PARTNERS3 Filed as: LSG INSURANCE PARTNERS, INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $745 | $3K | 4.59% |
| LSG INSURANCE PARTNERS3 Filed as: LSG INSURANCE PARTNERS, INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $311 | $4K | 16.19% |
| LSG INSURANCE PARTNERS3 Filed as: LSG INSURANCE PARTNERS, INC | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 48302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $242 | $3K | 16.22% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $411 | — | $411 | 10.00% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $290 | — | $290 | 10.01% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $245 | — | $245 | 10.07% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $218 | — | $218 | 10.02% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $205 | — | $205 | 10.86% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $99 | — | $99 | 9.92% |
| LSG INSURANCE PARTNERS3 | 2600 S. TELEGRAPH RD, STE 100 BLOOMFIELD HILLS, MI 483020968 | UNITEDHEALTHCARE INSURANCE COMPANY | $76 | — | $76 | 10.05% |
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 | 2,599 | 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) | 2,599 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 370 | $815K |
| Dental | DELTA DENTAL OF MICHIGAN | 636 | $74K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 786 | $77K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 786 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $25K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 370 | $800K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 786 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 786 | — |
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.