| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $33K | $0 | $33K | 4.00% |
| ROBERT S. VANDERVEEN3 | 555 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $3K | $2K | $5K | 7.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PARKWAY, SUITE 500 KANSAS CITY, MO 64114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $488 | $488 | 1.09% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | PRIORTY HEALTH INSURANCE COMPANY | $1K | $0 | $1K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | VISION SERVICES PLAN | $1K | $0 | $1K | 9.91% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 180 | $861K |
| Dental | DELTA DENTAL OF MICHIGAN | 222 | $62K |
| Vision | VISION SERVICES PLAN | 104 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $45K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $45K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 180 | $861K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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.