| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE & CO., INC. | P.O. BOX 1801 ADRIAN, MI 49221 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 4.60% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 8.39% |
| KAPNICK & COMPANY, INC.3 | P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $521 | $5K | 15.42% |
| KAPNICK & COMPANY, INC.3 | P.O. BOX 1801 ADRIAN, MI 49221 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $463 | $2K | 17.51% |
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 | 149 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 158 | $662K |
| Dental | DELTA DENTAL OF MICHIGAN | 145 | $59K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $13K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 25 | $31K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 158 | $497K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.