| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KATHERINE C WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 4.54% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | — | $82 | $82 | 0.14% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $2K | $5K | 8.58% |
| CENTRO BENEFITS RESEARCH LLC3 | STE 300 325 N KIRKWOOD RD KIRKWOOD, MO 63122 | STARMOUNT LIFE INSURANCE COMPANY | — | $3K | $3K | 5.47% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $7K | 22.97% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 23.79% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND CO. INC. | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | VISION SERVICE PLAN | $651 | — | $651 | 8.18% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $540 | $2K | 21.93% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $519 | $262 | $781 | 22.57% |
| BRIAN PATRICK KELLY3 Filed as: BRIAN MORRISON | 22156 MARLOW ST OAK PARK, MI 48237 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $503 | $423 | $926 | 32.67% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DR ADRIAN, MI 49221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $318 | $113 | $431 | 15.21% |
| W F HILL AND ASSOCIATES INC3 Filed as: W F HILL & ASSOCIATES INC | 30700 TELEGRAPH RD STE 2620 BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $244 | $106 | $350 | 12.35% |
| ROBIN W BASIL3 | 30700 TELEGRPAH RD STE 2620 BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $248 | $94 | $342 | 12.07% |
| EVETTE SUSAN KENDZIERSKI3 Filed as: EVETTE SUSAN KENDRIRSKI | 22596 CLEARWATER DR MACOMB, MI 48044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $216 | $222 | 7.83% |
| HERBERT LAVON GRAHAM3 | 20787 STAFFORD ST CLNTON TWNSHP, MI 48035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $17 | $59 | 2.08% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $5 | $5 | 0.29% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $54 | — | $54 | 15.00% |
| KATHERINE C WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $41K | — | $41K | — |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | — | $1K | $1K | — |
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 | 96 | 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. |
| Total participants (= "Plan participants" tile) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 135 | $57K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 63 | $54K |
| Vision | VISION SERVICE PLAN | 45 | $8K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $6K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 45 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18 | $8K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 135 | $57K |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.