| 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 | 2.05% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 492489248 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.12% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $8K | $344 | $9K | 5.05% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 18.02% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 17.90% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.09% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | VISION SERVICE PLAN | $1K | — | $1K | 5.22% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DR ADRIAN, MI 49221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $525 | — | $525 | 5.23% |
| THOMAS W BOSTON3 Filed as: THOMAS A. DANKO | 51110 SHADOW RIDGE DR MACOMB, MI 48042 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | — | $53 | 0.53% |
| VICE PRESIDENT EXCEPTION TO PROCESS3 | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.28% |
| ANTHONY BUDIMEROVICH3 Filed as: ANTHONY J. BUDIMERIVOCH | 625 E. BIG BEAVER ROAD SUITE 103 TROY, MI 48083 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.26% |
| SHAUN M KLUG3 | 957 HILLDALE RD BENTON HARBOR, MI 49022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.09% |
| 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 | $0 | $4K | $4K | — |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $125 | $125 | — |
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 | 204 | 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) | 211 | 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 | 318 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 350 | $170K |
| Vision | VISION SERVICE PLAN | 158 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $68K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 196 | $38K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 318 | $1.7M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.