| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH MADZIAR3 | 1201 BRIARWOOD CIR ANN ARBOR, MI 48108 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $27K | — | $27K | 3.01% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | PO BOX 1801 ADRIAN, MI 49221 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.29% |
| ELIZABETH MADZIAR3 | 1201 BRIARWOOD CIRCLE ANN ARBOR, MI 48108 | BLUE CARE NETWORK OF MICHIGAN | $14K | — | $14K | 3.03% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC | PO BOX 1801 ADRIAN, MI 492219221 | BLUE CARE NETWORK OF MICHIGAN | — | $574 | $574 | 0.12% |
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK & COMPANY INC. | 333 INDUSTRIAL DR ADRIAN, MI 49221 | DEARBORN LIFE INSURANCE COMPANY | $8K | $6K | $14K | 24.08% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 174 | 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 | 183 | $1.4M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 183 | $901K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 183 | $901K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 168 | $56K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 168 | $56K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 168 | $56K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 183 | $1.4M |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 226 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.