| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC J LASCESKI3 | 1100 SUPERIOR AVE STE 1500 CLEVELAND, OH 44114 | BLUE CARE NETWORK OF MICHIGAN | $48K | — | $48K | 2.72% |
| NAILE PALAJ3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 0.25% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | — | $1K | $1K | 0.07% |
| MARC J LASCESKI3 | 1100 SUPERIOR AVE STE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 2.62% |
| NAILE PALAJ3 | 333 INDUSTRIAL DRIVE ADRIAN, MI 49248 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $1K | — | $1K | 0.51% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $380 | $380 | 0.13% |
| THE JAMES B OSWALD COMPANY3 Filed as: THE JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE SUITE 1500 CLEVELAND, OH 44114 | GUARDIAN LIFE INSURANCE COMPANY | $30K | — | $30K | 16.69% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD. STE 300 KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY | $9K | — | $9K | 4.95% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DR ADRIAN, MI 49221 | GUARDIAN LIFE INSURANCE COMPANY | $3K | $3K | $6K | 3.37% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE | $2K | — | $2K | 13.43% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVE, STE 1500 OSWALD CENTRE CLEVELAND, OH 44114 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE | $2K | — | $2K | 13.43% |
| ASSUREDPARTNERS4 Filed as: ASSURED PARTNERS OF MI DBA JS CLARK | 25900 W 11 MILE RD. STE 210 SOUTHFIELD, MI 48034 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $216 | — | $216 | 2.57% |
| SCHILLER & ASSOCIATES LLC4 | 173 COTTAGE LN. MILFORD, MI 48381 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $216 | — | $216 | 2.57% |
| KAPNICK & COMPANY, INC.4 Filed as: KAPNICK & COMPANY INC | 333 INDUSTRIAL DR ADRIAN, MI 49221 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $191 | — | $191 | 2.27% |
| THE JAMES B OSWALD COMPANY4 Filed as: THE JAMES B OSWALD COMPANIES | 1100 SUPERIOR AVE E STE 1500 CLEVELAND, OH 44114 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $72 | — | $72 | 0.86% |
| SWEET T'S VENTURE LLC4 | 3421 BRENTWOOD DR. FLINT, MI 48503 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $53 | — | $53 | 0.63% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 228 | $2.1M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 143 | $178K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE | 216 | $14K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY | 143 | $178K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY | 143 | $178K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY | 143 | $178K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 228 | $2.1M |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 143 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.