| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANGELA M DEAN3 Filed as: ANGELA M. DEAN | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $38K | $0 | $38K | 1.53% |
| SHERI L CRIFASI3 Filed as: SHERI L. CRIFASI | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $36K | $0 | $36K | 1.46% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $3K | $3K | 0.12% |
| SHERI L CRIFASI3 Filed as: SHERI L. CRIFASI | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | BLUE CARE NETWORK OF MICHIGAN | $18K | $0 | $18K | 1.75% |
| ANGELA M DEAN3 Filed as: ANGELA M. DEAN | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | $12K | $0 | $12K | 1.22% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | $0 | $1K | $1K | 0.11% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 4.43% |
| ASSUREDPARTNERS3 | 13900 LAKESIDE CIRCLE STERLING HEIGHTS, MI 48313 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 3.04% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 NORTH KIRKWOOD ROAD, SUITE 300 KIRKWOOD, MO 63122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 2.57% |
| ASSUREDPARTNERS3 | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 1.47% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $0 | $410 | $410 | 0.26% |
| ASSUREDPARTNERS3 | 3099 BIDDLE AVENUE WYANDOTTE, MI 48192 | NGL | $2K | $0 | $2K | 5.76% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | NGL | $2K | $0 | $2K | 4.24% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 9.15% |
| ASSUREDPARTNERS3 | 13900 LAKESIDE CIRCLE STERLING HEIGHTS, MI 48313 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.25% |
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 | 297 | 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) | 297 | 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 | 322 | $3.5M |
| Dental | DELTA DENTAL OF MICHIGAN | 507 | $156K |
| Vision | NGL | 444 | $43K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 297 | $166K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 297 | $166K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 297 | $166K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 322 | $3.5M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 297 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.