| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 | PO BOX 1801 ADRIAN, MI 48221 | UNUM | $35K | $0 | $35K | 14.38% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | 1201 BRIARWOOD CIR ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 3.28% |
| KATHERINE C WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 3.32% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE CO | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $3K | $3K | 2.03% |
| ASSOCIATION BENEFITS CO3 | 24600 NORTHWESTERN HWY SOUTHFIELD, MI 48075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 1.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Float revenue; Contract Administrator; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 12 | — | $256K |
| BLUE CROSS BLUE SHIELD | Non-monetary compensation Service code 56 | — | $9K |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 331 | $169K |
| Dental | DELTA DENTAL OF MICHIGAN | 771 | $218K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 331 | $169K |
| Life insurance | UNUM | 331 | $242K |
| Short-term disability | UNUM | 331 | $242K |
| Long-term disability | UNUM | 331 | $242K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 331 | $169K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 331 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 771 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.