| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRAVIS PORTA3 | 7219 GRAND RIVER ROAD BRIGHTON, MI 48114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | $0 | $28K | 1.78% |
| WILLIAM HARTSFIELD, JR.3 Filed as: WILLIAM HARTSFIELD JR | 115 OFFICE PARK DRIVE, SUITE 200 BIRMINGHAM, AL 35223 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $21K | $0 | $21K | 1.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.15% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS ALLEN CAPITAL, LLC | 115 OFFICE PARK DRIVE, SUITE 200 MOUNTAIN BRK, AL 35223 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 5.62% |
| HUB INTERNATIONAL MIDWEST LIMITED5 | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 5.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LIMITED. | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 3.99% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 2.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 6.72% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS ALEN CAPITAL, LLC | 115 OFFICE PARK DRIVE, SUITE 200 MOUNTAIN BRK, AL 35223 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 2.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LA SALLE STREET 20T FLOOR CHICAGO, IL 60601 | DELTA DENTAL OF MICHIGAN | $922 | — | $922 | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 11.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 7219 GRAND RIVER ROAD BRIGHTON, MI 48114 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 5.23% |
| COBBS ALLEN & HALL INC3 Filed as: COBBS ALLEN CAPITAL, LLC | 416 WEST 13TH STREET, SUITE 303 NEW YORK, NY 10014 | PRINCIPAL LIFE INSURANCE COMPANY | $705 | — | $705 | 3.61% |
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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 351 | $1.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 337 | $112K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 315 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 227 | $170K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 227 | $170K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 227 | $170K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 351 | $1.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 227 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.