| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN GRACIN3 Filed as: STEPHEN J PECK | 769 CHICAGO RD TROY, MI 480838083 | BLUE CARE NETWORK OF MICHIGAN | $22K | — | $22K | 1.15% |
| DAVID F. HUNTZICKER3 | 1201 BRIARWOOD CR. ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $9K | — | $9K | 0.45% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | — | $2K | $2K | 0.09% |
| STEPHEN GRACIN3 Filed as: STEPHEN J PECK | 769 CHICAGO RD TROY, MI 480838083 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $12K | — | $12K | 1.16% |
| DAVID F. HUNTZICKER3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 0.38% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.14% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY | 1201 BRIARWOOD CIR ANN ARBOR, MI 48108 | EMPLOYEE HEALTH INSURANCE MANAGEMENT INC | $41K | — | $41K | 5.07% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $27K | — | $27K | 11.13% |
| CATHERINE HILTZ3 | 769 CHICAGO AVE TROY, MI 48084 | DEARBORN LIFE INSURANCE COMPANY | $28K | — | $28K | 11.78% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DR. ADRIAN, MI 49221 | DEARBORN LIFE INSURANCE COMPANY | — | $12K | $12K | 4.85% |
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 | 365 | 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) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 423 | $3.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 582 | $241K |
| Vision(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 423 | $2.9M |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 365 | $241K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 365 | $241K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 365 | $241K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CARE NETWORK OF MICHIGAN | 423 | $3.8M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 365 | $241K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 582 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.