| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH MADZIAR3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481088108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $42K | $0 | $42K | 5.22% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481081690 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.14% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.48% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 19.25% |
| ELIZABETH MADZIAR3 | KAPNICK COMPANY, INC. 1201 BRIARWOOD CR. ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $532 | — | $532 | 1.81% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $932 | $4K | 19.47% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $626 | — | $626 | 15.01% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $625 | $199 | $824 | 19.77% |
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 | 125 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 172 | $807K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 175 | $34K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 172 | $807K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $39K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $21K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 172 | $807K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 125 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.