| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRUCE J. WALDECKER3 | 2780 44TH STREET SW WYOMING, MI 49519 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $47K | $0 | $47K | 1.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $13K | $13K | 0.47% |
| DOUGLAS WILLIAM JR NAGEL3 Filed as: DOUGLAS WILLIAM NAGEL JR. | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | -$6K | $0 | -$6K | -0.22% |
| OLIVIER VANDYK INSURANCE3 Filed as: OLIVIER-VANDYK INSURANCE | 2780 44TH STREET SW WYOMING, MI 49519 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $0 | $16K | 6.99% |
| OLIVIER VANDYK INSURANCE3 Filed as: OLIVIER-VANDYK INSURANCE | 2780 44TH STREET SW WYOMING, MI 49519 | DELTA DENTAL OF MICHIGAN | $7K | $233 | $7K | 3.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $0 | $5K | $5K | 2.08% |
| OLIVIER VANDYK INSURANCE3 Filed as: OLIVIER-VANDYK INSURANCE | 2780 44TH STREET SW WYOMING, MI 49519 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $6K | — | $6K | 18.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $82 | $0 | $82 | 0.25% |
| BRUCE J. WALDECKER3 | 2780 44TH STREET SW WYOMING, MI 49519 | BLUE CARE NETWORK OF MICHIGAN | $180 | $0 | $180 | 0.96% |
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 | 355 | 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) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 656 | $2.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 693 | $218K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 635 | $32K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $235K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $235K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $235K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 656 | $2.9M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 347 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 693 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.