| 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 | $50K | — | $50K | 3.26% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 492489248 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $936 | $936 | 0.06% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $7K | $127 | $7K | 4.48% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 18.98% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.19% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 19.10% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | VISION SERVICE PLAN | $1K | — | $1K | 5.47% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DR ADRIAN, MI 49221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $765 | — | $765 | 7.49% |
| THOMAS W BOSTON3 Filed as: THOMAS A. DANKO | 51110 SHADOW RIDGE DR MACOMB, MI 48042 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | — | $36 | 0.35% |
| ANTHONY BUDIMEROVICH3 Filed as: ANTHONY J. BUDIMERIVOCH | 625 E. BIG BEAVER ROAD SUITE 103 TROY, MI 48083 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| SHAUN M KLUG3 | 957 HILLDALE RD BENTON HARBOR, MI 49022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48101 | GERBER LIFE INSURANCE COMPANY | $290 | — | $290 | 14.99% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | — |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $164 | $164 | — |
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 | 182 | 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) | 189 | 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 | 271 | $1.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 310 | $155K |
| Vision | VISION SERVICE PLAN | 140 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $77K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 271 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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."
No prospect flags tripped on this filing.