| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 8.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 427 BENTON, KY 42025 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $5K | 15.74% |
| JEREMY SAMPSEL3 | 401 HALL STREET SW, SUITE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $516 | $440 | $956 | 13.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 392 TRAVERSE CITY, MI 49685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $509 | $97 | $606 | 8.70% |
| DIANNA LYNN ATCHISON3 | 225 EAST DIVISION STREET ROCKFORD, MI 49341 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $200 | $47 | $247 | 3.55% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH JACKSON, MI 49201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $99 | $0 | $99 | 1.42% |
| BRAD SCOFFIN3 Filed as: BRAD SCOFFIN AND OTHER AGENTS | 7976 EAST U AVENUE VICKSBURG, MI 49097 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $3 | $91 | 1.31% |
| ALTRUIS BENEFIT CONSULTING INC3 Filed as: ALTRUIS BENEFIT CONSULTING | 30600 TELEGRAPH ROAD BINGHAM FARMS, MI 48025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $81 | $0 | $81 | 1.16% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 1.13% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 73 | $340K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 79 | $40K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 79 | $40K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 181 | $32K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 181 | $39K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 181 | $32K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.