| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT V. WEILAND3 Filed as: ROBERT VICTOR WEILAND II | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $25K | — | $25K | 1.77% |
| KAPNICK & COMPANY, INC.3 | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.09% |
| ROBERT V. WEILAND3 Filed as: ROBERT WEILAND II | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CARE NETWORK OF MICHIGAN | $9K | — | $9K | 2.06% |
| KAPNICK & COMPANY, INC.3 | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | — | $681 | $681 | 0.15% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $3K | $13K | 9.73% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $6K | $300 | $6K | 4.99% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE P.O. BOX 1801 ADRIAN, MI 49221 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 189 | 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 | 215 | $1.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 334 | $128K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 146 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $132K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $132K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $132K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 215 | $1.9M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 186 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 334 | — |
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.