| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $19K | $0 | $19K | 1.37% |
| DOUG CALKINS3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 0.45% |
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $7K | $0 | $7K | 1.41% |
| DOUG CALKINS3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $2K | $0 | $2K | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 40 EAST ALAMAR AVENUE SANTA BARBARA, CA 93105 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $5K | $5K | 3.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | AMERITAS LIFE INSURANCE CORPORATION | $4K | $0 | $4K | 2.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 12.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 4.55% |
| TODD J STRBIK3 Filed as: TODD J. STRBIK | 1727 NEMOKE TRAIL, SUITE 4 HASLETT, MI 48840 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $213 | $2K | 5.26% |
| WILLIAM OLIVER LAMB3 | 9404 PINEVIEW COURT DAVISON, MI 48423 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $648 | $34 | $682 | 2.18% |
| LEONARD T. WRIGHT3 Filed as: LEONARD THOMAS WRIGHT | PO BOX 118 CORUNNA, MI 48817 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $148 | $0 | $148 | 0.47% |
| JERMEY D. SAMPSEL3 Filed as: JERMEY SAMPSEL | 3030 SOUTH 9TH STREET KALAMAZOO, MI 49009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $85 | $133 | 0.43% |
| PATRICK JAMES MALAK3 | 8350 BYRON CENTER AVENUE SW BYRON CENTER, MI 49315 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $0 | $116 | 0.37% |
| JOHN CHRISTOPHER SCHEMANSKE3 | 1865 SOUTH MILFORD ROAD MILFORD, MI 48381 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
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 | 195 | 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) | 195 | 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 | 323 | $1.9M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 259 | $133K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 259 | $133K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 195 | $105K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 195 | $105K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 195 | $105K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 323 | $1.9M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 195 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.