| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID J MCCLELLAN3 Filed as: DAVID GANGI | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CARE NETWORK OF MICHIGAN | $19K | — | $19K | 2.06% |
| CHRISTINA M LOSIER3 | ONE WOODWARD AVENUE SUITE 1500 DETROIT, MI 482265479 | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 0.17% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481081690 | BLUE CARE NETWORK OF MICHIGAN | — | $773 | $773 | 0.08% |
| DAVID J MCCLELLAN3 Filed as: DAVID GANGI | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $18K | $1K | $19K | 2.63% |
| CHRISTINA M LOSIER3 | ONE WOODWARD AVENUE SUITE 1500 DETROIT, MI 482265479 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.44% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481081690 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.17% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $608 | $4K | 8.26% |
| LOVASCO CONSULTING GROUP INC3 | ONE WOODWARD AVENUE STE 1500 DETROIT, MI 48226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $169 | $2K | 3.53% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $255 | $2K | 9.87% |
| LOVASCO CONSULTING GROUP INC3 | ONE WOODWARD AVENUE STE 1500 DETROIT, MI 48226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $69 | $1K | 6.60% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 49221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $525 | $29 | $554 | 3.92% |
| MICHAEL PANNUTO3 Filed as: MICHAEL P. PANNUTO | 45445 MOUND ROAD SUITE 102 UTICA, MI 48317 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 1.30% |
| METRO WORKSITE SERVICES INC.3 | P. O. BOX 39300 REDFORD, MI 48239 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 1.24% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $203 | — | $203 | 4.06% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CARE NETWORK OF MICHIGAN | 342 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 342 | $706K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 342 | $706K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 159 | $81K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 43 | $14K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 159 | $53K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 342 | $1.6M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 159 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.