| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KATHERINE C WOOD3 | 1201 BRIARWOOD CIRCLE STE 2300 ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $101K | — | $101K | 4.01% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.12% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $9K | — | $9K | 5.91% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR. ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 10.83% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 18.31% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MA 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 20.15% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | 333 INDUSTRIAL DR. ADRIAN, MI 49221 | NATIONAL VISION ADMINISTRATORS (NGL) | $2K | — | $2K | 10.00% |
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 | 304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 468 | $2.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 501 | $156K |
| Vision | NATIONAL VISION ADMINISTRATORS (NGL) | 489 | $21K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $143K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $47K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $93K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 468 | $2.5M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 304 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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.