| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID F. HUNTZICKER3 Filed as: DAVID F HUNTZICKER | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $33K | — | $33K | 3.08% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.19% |
| DAVID F. HUNTZICKER3 Filed as: DAVID F HUNTZICKER | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $9K | — | $9K | 3.31% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | — | $443 | $443 | 0.16% |
| THOMAS KARLE3 Filed as: THOMAS M KARLE | 20844 HARPER AVE SUITE 101 HARPER WOODS, MI 48225 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 3.07% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & CO INC | 333 INDUSTRIAL DR ADRIAN, MI 49221 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 2.17% |
| AUTOMOBILE DEALERS ACCESSORY CORP3 | 1500 KENDALE BOULEVARD EAST LANSING, MI 48823 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $178 | $178 | 0.17% |
| MICHIGAN AUTOMOBILE DEALERS ASSOC3 | 1500 KENDALE BOULEVARD EAST LANSING, MI 48823 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $8 | $8 | 0.01% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$1K | — | -$1K | -1.27% |
| THOMAS KARLE3 Filed as: THOMAS M. KARLE | 20844 HARPER AVE #101 HARPER WOODS, MI 48225 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.79% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 Filed as: FLORIDA AUTOMOBILE DEALERS ASSOCIAT | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $2K | $2K | 2.02% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$648 | — | -$648 | -0.80% |
| THOMAS KARLE3 | 651 WASHINGTON GROSS POINTE, MI 48230 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 7.76% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $688 | $38 | $726 | 5.36% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $293 | — | $293 | 2.16% |
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 | 165 | 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) | 165 | 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 | 171 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $1.1M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 165 | $14K |
| Short-term disability(2 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 57 | $186K |
| Long-term disability(2 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 57 | $186K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $1.3M |
| Other(3 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 165 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.