| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KATHLEEN C WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481081690 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $34K | — | $34K | 20.05% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 492489248 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $5K | $5K | 3.26% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.71% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | VISION SERVICE PLAN | $1K | — | $1K | 5.36% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DR ADRIAN, MI 49221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 11.03% |
| THOMAS W BOSTON3 Filed as: THOMAS A. DANKO | 51110 SHADOW RIDGE DR MACOMB, MI 48042 | CONTINENTAL AMERICAN INSURANCE COMPANY | $164 | — | $164 | 1.26% |
| ANTHONY BUDIMEROVICH3 Filed as: ANTHONY J. BUDIMERIVOCH | 625 E. BIG BEAVER ROAD SUITE 103 TROY, MI 48083 | CONTINENTAL AMERICAN INSURANCE COMPANY | $72 | — | $72 | 0.55% |
| VICE PRESIDENT EXCEPTION TO PROCESS3 | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48101 | GERBER LIFE INSURANCE COMPANY | $306 | — | $306 | 15.00% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | — |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 326 | $181K |
| Dental | DELTA DENTAL OF MICHIGAN | 368 | $162K |
| Vision | VISION SERVICE PLAN | 152 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $68K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $38K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 326 | $168K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.