| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $13K | 17.00% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $915 | $8K | 17.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Insurance services; Other fees; Contract Administrator; Float revenue Service code 12 | — | $224K |
| DEBRA A YOUNGS INSURANCE AGENT | Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions; Insurance agents and brokers; Other fees Service code 22 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | $21K |
| KAPNICK & COMPANY, INC. INSURANCE AGENT | Other fees; Other commissions; Non-monetary compensation; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $4K |
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 | 281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 313 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $123K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $78K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.