| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH MADZIAR3 | 1201 BRIARWOOD CIR ANN ARBOR, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $51K | — | $51K | 2.97% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.12% |
| ELIZABETH MADZIAR3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $6K | — | $6K | 2.73% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CARE NETWORK OF MICHIGAN | — | $343 | $343 | 0.15% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY, INC | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | DELTA DENTAL | $5K | $450 | $6K | 5.43% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | AMERICAN UNITED LIFE INSURANCE COMPANY | $15K | $3K | $18K | 18.00% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD SUITE 300 KIRKWOOD, MO 63122 | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $5K | $5K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | — | AMERICAN UNITED LIFE INSURANCE COMPANY | — | $3K | $3K | 3.00% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK INSURANCE GROUP | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | EYEMED | $3K | — | $3K | 25.20% |
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 | 269 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 271 | 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 | 245 | $1.9M |
| Dental | DELTA DENTAL | 295 | $108K |
| Vision | EYEMED | 260 | $12K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 269 | $98K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 269 | $98K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 245 | $1.9M |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 311 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.