| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICK D DALTON3 Filed as: PATRICK D. DALTON | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $78K | $0 | $78K | 1.34% |
| MICHELLE R. STOUFFER3 | 50 LOUIS STREET NW, SUITE 510 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | $0 | $8K | 0.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $6K | $6K | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49418 | AMERITAS LIFE INSURANCE CORP. | $34K | $0 | $34K | 9.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49418 | TRANSAMERICA LIFE INSURANCE COMPANY | $37K | $0 | $37K | 15.00% |
| DISABILITY RMS5 | PO BOX 9757 PORTLAND, ME 04104 | TRANSAMERICA LIFE INSURANCE COMPANY | $0 | $30K | $30K | 12.31% |
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 | 671 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 673 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,104 | $5.8M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 1,225 | $378K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 1,225 | $378K |
| Life insurance | TRANSAMERICA LIFE INSURANCE COMPANY | 671 | $244K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 671 | $244K |
| Long-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 671 | $244K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,104 | $5.8M |
| Other(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 671 | $252K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,225 | — |
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.