| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 7.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LMITED | PO BOX 427 BENTON, KY 42025 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $6K | 14.56% |
| JEREMY SAMPSEL3 | 401 HALL STREET SW, SUITE 225 GRAND RAPIDS, MI 49503 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $659 | $721 | $1K | 19.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 392 TRAVERSE CITY, MI 49685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $633 | $134 | $767 | 10.82% |
| DIANNA LYNN ATCHISON3 | 225 EAST DIVISION STREET ROCKFORD, MI 49341 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $227 | $105 | $332 | 4.68% |
| FANTASIA MARIE JONES & OTHER AGENTS3 | 420 CEDAR STREET, APARTMENT 4 PAW PAW, MI 49079 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $46 | $169 | 2.38% |
| MELISSA DEVON WRIGHT-HALMON3 | 1109 POINT NORTH JACKSON, MI 49201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $78 | $0 | $78 | 1.10% |
| EVETTE SUSAN KENDZIERSKI3 | 22596 CLEARWATER DRIVE MACOMB, MI 48044 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $72 | $0 | $72 | 1.02% |
| ALTRUIS BENEFIT CONSULTING INC3 Filed as: ALTRUIS BENEFIT CONSULTING | 30600 TELEGRAPH ROAD BINGHAM FARMS, MI 48025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $65 | $0 | $65 | 0.92% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 79 | $438K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 111 | $45K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 111 | $45K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 198 | $39K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 198 | $46K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 198 | $39K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 319 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.