| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | BLUE CARE NETWORK OF MICHIGAN | $10K | — | $10K | 2.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44ST SW GRANDVILLE, MI 49418 | BLUE CARE NETWORK OF MICHIGAN | $25K | — | $25K | 5.74% |
| JERRY NIEWIEK3 | PO BOX 953 GRANDVILLE, MI 49468 | BLUECROSS BLUE SHIELD OF TENNESSEE INC | $8K | — | $8K | 5.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGCY IN | PO BOX 953 GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $694 | $6K | 7.82% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | COMPANION LIFE | $3K | — | $3K | 5.10% |
| BENEFIT PROFILES INC | 4500 CASCADE ROAD SE STE 106 GRAND RAPIDS, MI 49546 | COMPANION LIFE | $1K | $16 | $1K | 2.33% |
| AGENT ALLIANCE CORPORATION | 4500 CASCADE RD SE SUITE 106 GRAND RAPIDS, MI 49546 | COMPANION LIFE | $132 | — | $132 | 0.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT | PO BOX 953 GRANDVILLE, MI 49468 | GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 13.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICEK STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | COMPANION LIFE | $476 | — | $476 | 9.69% |
| BENEFIT PROFILES INC3 Filed as: BENEFIT PROFILES INS | 4500 CASCADE ROAD SE STE 106 GRAND RAPIDS, MI 49546 | COMPANION LIFE | $215 | $16 | $231 | 4.70% |
| AGENT ALLIANCE CORPORATION3 | 4500 CASCADE ROAD SE SUITE 106 GRAND RAPIDS, MI 49546 | COMPANION LIFE | $24 | — | $24 | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | PO BOX 953 GRANDVILLE, MI 49468 | VISION SERVICE PLAN | $35 | — | $35 | 9.94% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 138 | $1.0M |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE | 151 | $56K |
| Vision(2 contracts, 2 carriers) | COMPANION LIFE | 28 | $5K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $99K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $99K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.