| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICK D DALTON3 | 3055 44TH ST GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | $6K | — | $6K | 4.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | PO BOX 953 GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 7.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | PO BOX 953 GRANDVILLE, MI 49468 | EYE MED | $743 | — | $743 | 9.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | 3055 44TH SW GRANDVILLE, MI 49418 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $628 | $308 | $936 | 19.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | PO BOX 953 GRANDVILLE, MI 49468 | VISION SERVICE PLAN | $51 | — | $51 | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSCOPE BENEFITS INC EIN 71-0347266 | Claims processing; Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 5150 DUBLIN GRANDVILLE RD SUITE 300 COLUMBUS, OH 43081 | $50K |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | 16 | $127K |
| Dental | DELTA DENTAL OF MICHIGAN | 161 | $55K |
| Vision | EYE MED | 111 | $8K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $5K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.