| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN GRACIN3 Filed as: STEPHEN J. PECK | 769 CHICAGO RD. TROY, MI 48083 | BLUE CARE NETWORK OF MICHIGAN | $43K | — | $43K | 2.97% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | — | $1K | $1K | 0.09% |
| STEPHEN GRACIN3 Filed as: STEPHEN J. PECK | 769 CHICAGO RD. TROY, MI 48083 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $10K | — | $10K | 2.99% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | — | $233 | $233 | 0.07% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 492219221 | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | $2K | — | $2K | 0.62% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 3.17% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CR ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $991 | — | $991 | 3.29% |
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 295 | $1.8M |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 190 | $78K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 352 | $10K |
| Life insurance | STANDARD INSURANCE COMPANY | 397 | $103K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 295 | $2.1M |
| Other | STANDARD INSURANCE COMPANY | 397 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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.