| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $146 | — | $146 | 0.10% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49248 | GUARDIAN | $19K | $3K | $22K | 16.06% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. STE 300 KIRKWOOD, MA 63122 | GUARDIAN | $7K | — | $7K | 5.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 10.85% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. STE 300 KIRKWOOD, MO 63122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.00% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49248 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 14.68% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 15.06% |
| ASSUREX GLOBAL CORPORATION3 | 6620 MOONEY ST. STE 360 DUBLIN, OH 43017 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $696 | $696 | 2.98% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR. ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 19.58% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49248 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $184 | $3K | 19.13% |
| W F HILL AND ASSOCIATES INC3 Filed as: WF HILL AND ASSOCIATES INC | 30700 TELEGRAPH RD BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $485 | $223 | $708 | 4.16% |
| ROBIN W BASIL3 | 30700 TELEGRAPH RD BINGHAM FARMS, MI 48025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | $105 | $413 | 2.43% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | ZURICH AMERICAN INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 3.66% |
| ASSUREX3 | 175 SOUTH 3RD STREET STE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $10 | $10 | 0.28% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49248 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $47 | — | $47 | 1.34% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $169 | — | $169 | 5.86% |
| ASSUREX GLOBAL CORPORATION3 | 6620 MOONEY ST. STE 360 DUBLIN, OH 43017 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $19 | $19 | 0.66% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 6.22% |
| ASSUREX3 | 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $24 | $24 | 1.01% |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 377 | $143K |
| Vision | GUARDIAN | 214 | $137K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 217 | $218K |
| Long-term disability(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 217 | $108K |
| Other(11 contracts, 7 carriers) | GUARDIAN | 229 | $302K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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.