| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACTION BENEFITS COMPANY3 | 26533 EVERGREEN RD SUITE 400 SOUTHFIELD, MI 48076 | BLUE CARE NETWORK OF MICHIGAN | $6K | — | $6K | 0.62% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.18% |
| JAY R SCHREIBMAN3 | 2600 S TELEGRAPH S-100 BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $5K | — | $5K | 1.99% |
| ROBERT V. WEILAND3 Filed as: ROBERT VICTOR II WEILAND | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 1.52% |
| ACTION BENEFITS COMPANY3 Filed as: ACTION BENEFITS | 26533 EVERGREEN RD SUITE 400 SOUTHFIELD, MI 48076 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1K | — | $1K | 0.48% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 1201 BRIARWOOD CIRCLE ANNARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $763 | $763 | 0.31% |
| LUBIN SCHWARTZ & GOLDMAN3 Filed as: LUBIN SCHWARTZ & GOLDMAN INC | 2600 S TELEGRAPH RD STE 100 BLOOMFIELD, MI 48302 | THE GUARDIAN INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 7.86% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | THE GUARDIAN INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 6.98% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 253 | $1.2M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 253 | $249K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 253 | $249K |
| Life insurance | THE GUARDIAN INSURANCE COMPANY OF AMERICA | 102 | $79K |
| Short-term disability | THE GUARDIAN INSURANCE COMPANY OF AMERICA | 102 | $79K |
| Long-term disability | THE GUARDIAN INSURANCE COMPANY OF AMERICA | 102 | $79K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 253 | $249K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.