| 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 | $117K | — | $117K | 2.51% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE & CO., INC | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 0.09% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 3.04% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $29K | $8K | $37K | 19.27% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $18K | $5K | $24K | 19.29% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | $5K | $22K | 19.04% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | VISION SERVICE PLAN | $2K | — | $2K | 2.67% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $2K | $10K | 19.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $7K | 19.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $934 | $4K | 19.24% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 21.50% |
| SCHILLER & ASSOCIATES LLC4 Filed as: SCHILLER & ASSOCIATES | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 57.11% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 62.45% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $443 | — | $443 | 27.06% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LN MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $734 | — | $734 | 50.24% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $531 | — | $531 | 37.87% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $576 | — | $576 | 57.60% |
| CHRISTINE WIERENGA4 | 15191 MERRIMAN ROAD LIVONIA, MI 48154 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $24 | — | $24 | 2.40% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $335 | — | $335 | 51.30% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LANE MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $7K | — | $7K | 6124.77% |
| CHRISTINE WIERENGA4 | 15191 LIVONIA, MI 48154 | PRE-PAID LEGAL SERVICES DBA LEGALSHIELD | $752 | — | $752 | 689.91% |
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 | 499 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,110 | $4.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 1,269 | $249K |
| Vision | VISION SERVICE PLAN | 387 | $93K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 370 | $123K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 286 | $247K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 85 | $115K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,110 | $4.7M |
| Other(13 contracts, 5 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 474 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,269 | — |
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."
No prospect flags tripped on this filing.