| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $9K | $637 | $9K | 3.23% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $14K | $30K | 12.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Other fees; Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Float revenue; Contract Administrator Service code 12 | — | $265K |
| DAVID F HUNTZICKER AGENT/BROKER | Other commissions; Other fees; Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees Service code 22 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 481081690 | $0 |
| KAPNICK & COMPANY, INC. AGENT/BROKER | Non-monetary compensation; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees; Other fees Service code 22 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49248 | $0 |
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 | 299 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 798 | $293K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $238K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $238K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $238K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 798 | — |
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.