| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIR ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $6K | $73 | $6K | 4.80% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & CO, INC. | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | EYEMED VISION CARE | $3K | — | $3K | 17.42% |
| MICHIGAN CHAMBER SERVICES, INC.3 Filed as: MICHIGAN CHAMBER SERVICES | 600 SOUTH WALNUT STREET LANSING, MI 489332209 | EYEMED VISION CARE | $993 | — | $993 | 5.81% |
| KELLY HARNESS3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $990 | $22K | $23K | — |
| KAPNICK & COMPANY, INC.3 | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Contract Administrator; Insurance services; Consulting (general); Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Float revenue Service code 12 | — | $116K |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 306 | $124K |
| Vision | EYEMED VISION CARE | 293 | $17K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 314 | $0 |
| Other | LIGHTHOUSE/HARBOR | 111 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.