| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID F. HUNTZICKER3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $56K | — | $56K | 3.79% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.10% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR ADRIAN, MI 49221 | PRINCIPAL LIFE INSURANCE COMPANY | $72K | $5K | $77K | 20.40% |
| DAVID F. HUNTZICKER3 Filed as: DAVID F HUNTZICKER | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $9K | — | $9K | 3.64% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | — | $364 | $364 | 0.14% |
| KAPNICK & COMPANY, INC.3 | 333 INDUSTRIAL DR. ADRIAN, MI 49221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 22.30% |
| SCOTT W DAVIDSON3 Filed as: SCOTT W. DAVIDSON | 7866 SLEEPY HOLLOW DR. NORTHVILLE, MA 48168 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 7.48% |
| HILLARY R EBNER3 | 15991 LAUDERDALE AVE BEVERLY HILLS, MI 48025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $626 | — | $626 | 1.56% |
| SHAUN M KLUG3 Filed as: SHAUN MICHAEL KLUG | 957 HILANDALE RD BENTON HARBOR, MI 49022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $345 | — | $345 | 0.86% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | HERITAGE VISION PLANS INC | $2K | — | $2K | 4.81% |
| TRACY KATZ LLC4 | 1662 E MELTON RD. BIRMINGHAM, MI 48009 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 11.17% |
| KAPNICK & COMPANY, INC.4 Filed as: KAPNICK NSURANCE GROUP | 233 INDUSTRIAL DR ADRIAN, MI 49248 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $812 | — | $812 | 8.08% |
| WALTER CRIDER4 | 4389 WESTOVER DR. WEST BLOOMFIELD, MI 48323 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $134 | — | $134 | 1.33% |
| PATTERSON BRYANT GROUP INC4 Filed as: PATTERSON BRYANT ASSOCIATES | 30600 TELEGRAPH RD. STE 2250 BINGHAM FARMS, MI 48025 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $125 | — | $125 | 1.24% |
| TRION SOLUTIONS INC.4 | 340 E. BIG BEAVER RD TROY, MI 48083 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $39 | — | $39 | 0.39% |
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 | 209 | 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) | 210 | 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 | 266 | $1.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 381 | $377K |
| Vision | HERITAGE VISION PLANS INC | 316 | $31K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 381 | $377K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 381 | $377K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 381 | $377K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 266 | $1.7M |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 104 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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.