| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY J HALL3 | 423 N MAIN ST ROYAL OAK, MI 48067 | BLUE CARE NETWORK OF MICHIGAN | $41K | — | $41K | 0.85% |
| KATHERINE C WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $30K | — | $30K | 0.62% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 13900 LAKESIDE CIRCLE STERLING HEIGHTS, MI 48313 | BLUE CARE NETWORK OF MICHIGAN | $0 | $4K | $4K | 0.09% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC-AMY HALL | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 2.34% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & CO, INC - KATHERINE WOOD | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 0.99% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC-AMY HALL | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $0 | $338 | $338 | 0.09% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 2.80% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 2.73% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $800 | — | $800 | 0.42% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 3.38% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.85% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $593 | — | $593 | 0.41% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 4.73% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.65% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $888 | — | $888 | 1.06% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MICHIGAN LLC | 3099 BIDDLE AVE WYANDOTTE, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.22% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.59% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.82% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP-ADRIAN, MI | 333 INDUSTRIAL DR ADRIAN, MI 49221 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.79% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.79% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.79% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP-ADRIAN, MI | 333 INDUSTRIAL DR ADRIAN, MI 49221 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.94% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.94% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.94% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP-ADRIAN, MI | 333 INDUSTRIAL DR ADRIAN, MI 49221 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $19 | — | $19 | 12.93% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $19 | — | $19 | 12.93% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 25900 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $19 | — | $19 | 12.93% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP-ADRIAN, MI | 333 INDUSTRIAL DR ADRIAN, MI 49221 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $12 | — | $12 | 8.45% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 3099 BIDDLE AVE WYANDOTTE, MI 48192 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $12 | — | $12 | 8.45% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF MI LLC DBA JS | 25600 WEST ELEVEN MILE RD SUITE 210 SOUTHFIELD, MI 48034 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $12 | — | $12 | 8.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMY J HALL | Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Insurance agents and brokers; Other commissions Service code 22 | 423 N MAIN STREET ROYAL OAK, MI 48067 | $41K |
| KATHERINE C WOOD | Other commissions; Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other fees Service code 22 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | $30K |
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 | 386 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 746 | $4.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 782 | $362K |
| Vision(4 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 332 | $53K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 383 | $149K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 367 | $192K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 357 | $143K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 746 | $4.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 383 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 782 | — |
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."
No prospect flags tripped on this filing.