| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASR HEALTH BENEFITS3 | — | SIRIUS AMERICA | $92K | — | $92K | 11.00% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | $2K | — | $2K | 0.41% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | AMERICAN UNITED LIFE INSURANCE COMPANY | $39K | — | $39K | 15.31% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY/AE MOURAD | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $15K | $485 | $16K | 8.67% |
| KAPNICK & COMPANY, INC.3 | 28277 DEQUINDRE ROAD MADISON HEIGHTS, MI 48071 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 18.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 TPA | Contract Administrator Service code 13 | — | $76K |
| EHIM PHARMACY BENEFIT MANAGER EIN 38-2776173 PHARMACY BENEFIT MANAGER | Claims processing; Contract Administrator Service code 12 | — | $8K |
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 | 310 | 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) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | 161 | $387K |
| Dental | DELTA DENTAL OF MICHIGAN | 501 | $180K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $27K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 310 | $258K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 310 | $258K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 310 | $258K |
| Prescription drug | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | 161 | $387K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA | 160 | $832K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 310 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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.