| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBRA A YOUNGS3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $103K | — | $103K | 3.41% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE & CO., INC | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $281 | $281 | 0.01% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DR ADRIAN, MI 492218780 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | — | $31K | 14.30% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE ROAD SUITE H1 NEW CASTLE, PA 161056145 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $334 | $3K | 1.35% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | P.O. BOX 1801 ADRIAN, MI 492217801 | VISION SERVICE PLAN | $2K | — | $2K | 3.38% |
| RYAN MORRIS3 | 2212 ORCHARD ROAD OTTAWA HILLS, OH 43606 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 9.38% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 7.62% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 3.06% |
| LAYNE FINANCIAL INC3 Filed as: LAYNE FINANCIAL | 315 GREEN RIDGE DR SUITE H 1 NEW CASTLE, PA 16015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 2.93% |
| MARK L HUFHAND3 | 1300 CHRISTMAS SEAL DRIVE NW CANTON, OH 44709 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $564 | — | $564 | 1.05% |
| ERIC D TROTOCHAUD3 Filed as: ERIC TROTOCHAUD | P.O. BOX 272 EAST LANSING, MI 48826 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $285 | — | $285 | 0.53% |
| MICHAEL C HURLEY3 | 7484 STATE ROUTE 195 ALGER, OH 45812 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $85 | — | $85 | 0.16% |
| DONALD BECK JR3 Filed as: DONALD ISAAC TILLOTSON | 5000 MASTERS LANE COLUMBUS, GA 31909 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.04% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $276 | $3K | 21.75% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 25.57% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $834 | — | $834 | 8.88% |
| RYAN MORRIS3 | 2212 ORCHARD RD OTTAWA HILLS, OH 43606 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $608 | — | $608 | 6.47% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE DRIVE, SUITE H1 NEW CASTLE, PA 16015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $192 | — | $192 | 2.04% |
| MARK L HUFHAND3 | 1300 CHRISTMAS SEAL DRIVE NW CANTON, OH 44709 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66 | — | $66 | 0.70% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DR ADRIAN, MI 49221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47 | — | $47 | 0.50% |
| MICHAEL C HURLEY3 | 7484 STATE ROUTE 195 ALGER, OH 45812 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.16% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER & ASSOCIATES | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $272 | — | $272 | 51.52% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $67 | — | $67 | 17.59% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $61 | — | $61 | 16.22% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $138 | — | $138 | 38.98% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LN MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $93 | — | $93 | 58.13% |
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 | 372 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 722 | $3.0M |
| Vision | VISION SERVICE PLAN | 267 | $59K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 288 | $216K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 288 | $216K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 288 | $216K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 722 | $3.0M |
| Other(10 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 288 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 722 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.