| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KATHERIN C. WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, NE 48108 | BLUE CARE NETWORK OF MICHIGAN | $20K | $0 | $20K | 2.94% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | $0 | $3K | $3K | 0.46% |
| KATHERIN C. WOOD3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, NE 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $21K | $0 | $21K | 3.61% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.32% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 13.50% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL OF MICHIGAN | $4K | $159 | $5K | 7.05% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE | $1K | $0 | $1K | 9.99% |
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 | 110 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 163 | $1.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 267 | $65K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE | 176 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $70K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $70K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 163 | $1.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.