| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANGELA M DEAN3 | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $23K | — | $23K | 1.42% |
| CAMERON M KENNEDY3 | 400 W FOURTH STREET SUITE 300 ROYAL OAK, MI 480678067 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.09% |
| ANGELA M DEAN3 | PO BOX 1801 ADRIAN, MI 492217801 | BLUE CARE NETWORK OF MICHIGAN | $11K | — | $11K | 1.44% |
| CAMERON M KENNEDY3 | 400 W FOURTH STREET SUITE 300 ROYAL OAK, MI 480678067 | BLUE CARE NETWORK OF MICHIGAN | $0 | $841 | $841 | 0.11% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC./ANGELA DEAN | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 3.06% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 492219221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $447 | $7K | 12.75% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 492219221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $389 | $4K | 8.15% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 492219221 | NGL/NATIONAL VISION ADMINISTRATORS LLC | $3K | — | $3K | 10.00% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 492219221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $197 | $3K | 15.62% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DRIVE PO BOX 1801 ADRIAN, MI 492219221 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $665 | — | $665 | 11.56% |
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 | 374 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 385 | 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 | 226 | $2.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 406 | $119K |
| Vision | NGL/NATIONAL VISION ADMINISTRATORS LLC | 347 | $33K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $51K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $47K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $22K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 226 | $2.4M |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.