| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICK D DALTON3 | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $106K | — | $106K | 2.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS-HENDRICKS-STUIT INS. | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $4K | $4K | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 10.92% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $897 | $897 | 1.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 11.17% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $830 | $830 | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $9K | 17.96% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $491 | $491 | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $7K | 14.48% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $499 | $499 | 1.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | PO BOX 953 GRANDVILLE, MI 49468 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 9.25% |
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 | 359 | 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) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 616 | $3.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 616 | $3.6M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 471 | $34K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $127K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $86K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 616 | $3.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 616 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.