| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN GRACIN3 Filed as: STEPHEN J. PECK | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MS 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $38K | — | $38K | 2.88% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE & CO., INC. | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.08% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | QCA HEALTH PLAN | $13K | — | $13K | 3.07% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $7K | — | $7K | 6.72% |
| KAPNICK & COMPANY, INC.3 | P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $662 | $4K | 11.97% |
| KAPNICK & COMPANY, INC.3 | P.O, BOX 1801 ADRIAN, MI 49221 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $334 | $2K | 11.14% |
| KAPNICK & COMPANY, INC.3 | P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $332 | $2K | 13.13% |
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 | 215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | 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) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 289 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 304 | $102K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 289 | $1.3M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 202 | $49K |
| Long-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 156 | $18K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 289 | $1.3M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 202 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.