| 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 | $74K | — | $74K | 3.01% |
| KAPNICK & COMPANY, INC.3 | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.09% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.73% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 18.60% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.80% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.67% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | EYEMED VISION CARE | $2K | — | $2K | 9.90% |
| W F HILL AND ASSOCIATES INC3 Filed as: W F HILL AND ASSOCIATES INC. | 30700 TELEGRAPH RD. STE 2620 BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $683 | $555 | $1K | 17.33% |
| BALLARD FINANCIAL LLC3 | 17441 MADISON ST. SOUTHFIELD, MI 48076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $135 | $1K | 16.99% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DR ADRIAN, MI 49221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $127 | $1K | 16.91% |
| ROBIN W BASIL3 Filed as: ROBIN W. BASIL | 30700 TELEGRAPH RD. STE 2620 BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $288 | $139 | $427 | 5.98% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | ZURICH AMERICAN INSURANCE COMPANY | $293 | — | $293 | 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 | — | $165 | $165 | — |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 238 | 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 | 336 | $2.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 382 | $174K |
| Vision | EYEMED VISION CARE | 293 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $95K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $53K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 336 | $2.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 232 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 382 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.