| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANGELA M DEAN3 Filed as: ANGELA DEAN | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | PRIORITY HEALTH | $54K | $0 | $54K | 2.59% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF OHIO | $8K | $0 | $8K | 4.93% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $777 | $7K | 5.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2601 CAMBRIDGE COURT, SUITE 435 AUBURN HILLS, MI 48326 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $118 | $118 | 0.09% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.74% |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 459 | $2.1M |
| Dental | DELTA DENTAL OF OHIO | 473 | $161K |
| Vision | VISION SERVICE PLAN | 182 | $29K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $125K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $125K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $125K |
| Prescription drug | PRIORITY HEALTH | 459 | $2.1M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 473 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.