| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT V. WEILAND3 | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | $24K | — | $24K | 2.77% |
| ROBERT V. WEILAND3 Filed as: ROBERT V WEILAND | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $2K | — | $2K | 2.77% |
| KAPNICK & COMPANY, INC.3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 10.01% |
| SHEEHAN CONNOR J3 | 22447 ELENA DR FARMINGTON HILLS, MI 48335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.54% |
| JILL E. GLEBA3 | 5435 CORPORATE DRIVE SUITE 230 TROY, MI 48085 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $735 | — | $735 | 3.64% |
| SHEEHAN CONNOR J3 | 22447 ELENA DR FARMINGTON HILLS, MI 48335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 11.26% |
| JILL E. GLEBA3 Filed as: JILL E GLEBA | 5435 CORPORATE DRIVE SUITE 230 TROY, MI 48085 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $423 | — | $423 | 3.74% |
| SHEEHAN CONNOR J3 | 22447 ELENA DR FARMINGTON HILLS, MI 48335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $898 | — | $898 | 11.06% |
| JILL E. GLEBA3 | 5435 CORPORATE DRIVE SUITE 230 TROY, MI 48085 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $320 | — | $320 | 3.94% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 137 | $953K |
| Dental | DELTA DENTAL OF MICHIGAN | 142 | $64K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $32K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $20K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $28K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 137 | $953K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.