| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NAILE PALAJ3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $100K | $100K | 19.47% |
| NAILE PALAJ3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $26K | — | $26K | 10.88% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | P.O. BOX 1801 ADRIAN, MI 492219221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $7K | — | $7K | 2.99% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 17.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 17.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.61% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 769 CHICAGO RD. TROY, MI 48083 | EYEMED VISION CARE | $3K | — | $3K | 10.02% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 30150 TELEGRAPH RD S408 BINGHAM FARMS, MI 48205 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 23.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $69 | — | $69 | 1.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Direct payment from the plan; Claims processing; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Float revenue; Insurance services; Contract Administrator Service code 12 | PO BOX 2888 DETROIT, MI 48231 | $337K |
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 | 411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 418 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 841 | $244K |
| Vision | EYEMED VISION CARE | 837 | $26K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 506 | $97K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $79K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 415 | $511K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 506 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 841 | — |
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.