| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | $45K | — | $45K | 1.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | — | $3K | $3K | 0.12% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUTIE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $90K | — | $90K | 3.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $10K | — | $10K | 3.02% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUITE 200 GRAND RAPIDS, MI 49002 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 8.42% |
| RICHARD JOHN DERF3 Filed as: RICHARD DERF | PO BOX 143 GRAND HAVEN, MI 49417 | AFLAC | $3K | $271 | $3K | 8.67% |
| JEFFRY D DEKAM3 Filed as: JEFFRY DEKAM | 5481 SAND DUNE CT SW GRANDVILLE, MI 49418 | AFLAC | $569 | $52 | $621 | 1.87% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | AFLAC | $471 | $40 | $511 | 1.54% |
| KATHERINE HEERINGA3 | 7025 W BELL STE 3 GLENDALE, AZ 85308 | AFLAC | $443 | — | $443 | 1.33% |
| KIMBERLY S RAHRIG3 Filed as: KIMBERLY RAHRIG | 402 CHANNEL RD MUSKEGON, MI 49445 | AFLAC | $173 | — | $173 | 0.52% |
| JEREMY KOOI3 | 4001 FELLAND RD SUITE 106 MADISON, WI 53718 | AFLAC | $171 | — | $171 | 0.52% |
| AG AND ASSOCIATES3 Filed as: AG & ASSOCIATES | 2150 ASSOCIATION DR SUITE 150 OKEMOS, MI 48864 | AFLAC | $57 | $58 | $115 | 0.35% |
| JAMES BULLOCK3 | 3715 POWDERHORN DR OKEMOS, MI 48864 | AFLAC | $77 | $27 | $104 | 0.31% |
| JOAN M MCCORMICK3 Filed as: JOAN MCCORMICK | 10430 EAST GRANDVIEW ROAD TRAVERSE CITY, MI 49684 | AFLAC | $91 | — | $91 | 0.27% |
| CORE DESIGN LLC3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | AFLAC | $63 | $12 | $75 | 0.23% |
| ELWYN D JOSLIN3 | PO BOX 197 CEDAR SPRINGS, MI 49319 | AFLAC | $67 | — | $67 | 0.20% |
| JEFFREY C WERNER3 | 678-B FRONT AVE NW 91 GRAND RAPIDS, MI 49504 | AFLAC | $52 | — | $52 | 0.16% |
| ANDREW K GLAUB3 Filed as: ANDREW GLAUB | 2150 ASSOCIATION DRIVE SUITE 150 OKEMOS, MI 48864 | AFLAC | $52 | — | $52 | 0.16% |
| KENNETH BOWERY3 | 1039 BELLE RIVER WOODS BLVD EAST CHINA, MI 48054 | AFLAC | $51 | — | $51 | 0.15% |
| KEVIN L ERB3 Filed as: KEVIN ERB | 5080 DOWLING ST MONTAGUE, MI 49437 | AFLAC | $45 | — | $45 | 0.14% |
| JEFFREY P POLS3 | 5567 MADISON AVE HUDSONVILLE, MI 49426 | AFLAC | $40 | — | $40 | 0.12% |
| DAVID T BARCZAK3 Filed as: DAVID BARCZAK | 4345 COURTSIDE DR WILLIAMSTON, MI 48895 | AFLAC | $34 | — | $34 | 0.10% |
| JASON SCZEPANIAK3 | 4001 FELLAND RD STE 106 MADISON, WI 53718 | AFLAC | $33 | — | $33 | 0.10% |
| FRANK H MASON3 Filed as: FRANK MASON | PO BOX 1066 JACKSON, MI 49204 | AFLAC | $31 | — | $31 | 0.09% |
| ANGELA JONES3 | 101 WEST MAXLOW AVE HAZEL PARK, MI 48030 | AFLAC | $29 | — | $29 | 0.09% |
| SPAZ AND GLAUB ENTERPRISES3 | 2150 ASSOCIATION DRIVE SUITE 150 OKEMOS, MI 48864 | AFLAC | $26 | — | $26 | 0.08% |
| KEVIN CELL3 | 2391 M32 EAST JORDAN, MI 49727 | AFLAC | $15 | $11 | $26 | 0.08% |
| JULIE SLAUGHTER3 | 430 BOARDWALK WALLED LAKE, MI 48390 | AFLAC | $17 | $6 | $23 | 0.07% |
| DONALD POSTMA3 | 53 SKYLINE CIRCLE NW GRAND RAPIDS, MI 49504 | AFLAC | $22 | — | $22 | 0.07% |
| BENJAMIN HUNTER3 | 735 S GARFIELD AVE SUITE 203 TRAVERSE CITY, MI 49686 | AFLAC | $20 | $2 | $22 | 0.07% |
| STEVEN MILLER3 | 15 IONIA SW STE 350 GRAND RAPIDS, MI 49503 | AFLAC | $20 | — | $20 | 0.06% |
| JOHN HERNANDEZ3 | 1135 W MAPLE AVE ADRIAN, MI 49221 | AFLAC | $19 | — | $19 | 0.06% |
| DAVID J DOWDY3 Filed as: DAVID DOWDY | 3929 SIERRA HEIGHTS HOLT, MI 48842 | AFLAC | $18 | — | $18 | 0.05% |
| WILLIAM J CAMPBELL3 Filed as: WILLIAM CAMPBELL | PO BOX 66809 ST. PETERSBURG BEACH, FL 33736 | AFLAC | $16 | — | $16 | 0.05% |
| BENEFIT INNOVATIONS LL3 | 5567 MADISON AVE HUDSONVILLE, MI 49426 | AFLAC | $15 | — | $15 | 0.05% |
| JONI VERMEER3 | 279 SUMMIT ROCKFORD, MI 49341 | AFLAC | $15 | — | $15 | 0.05% |
| JEREMY SAMPSEL3 | 678 FRONT AVE R GRAND RAPIDS, MI 49504 | AFLAC | $14 | — | $14 | 0.04% |
| TAMIE E KAUFMAN3 Filed as: TAMIE KAUFMAN | 2227 QUERRY EAST LANSING, MI 48823 | AFLAC | $12 | — | $12 | 0.04% |
| DOUGLAS E FOX3 | 120 BOARDMAN AVE STE B TRAVERSE CITY, MI 49684 | AFLAC | $10 | $2 | $12 | 0.04% |
| JEFFREY D HARNED3 Filed as: JEFFREY XAVER | 4477 WOLVERINE DR WILLIAMBURG, MI 49690 | AFLAC | $10 | — | $10 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: RONALD BROWN | 930 WINGATE DR STE E E1 CONWAY, AR 72034 | AFLAC | $10 | — | $10 | 0.03% |
| JAMES C SNIDER JR3 | 3631 BAY HARBOR DR BRIGHTON, MI 48114 | AFLAC | $10 | — | $10 | 0.03% |
| MIELKE INSURANCE INC3 Filed as: MIELKE INSURANCE CO | PO BOX 26 CHARLEVOIX, MI 49720 | AFLAC | $8 | $2 | $10 | 0.03% |
| DARRELL JOSLIN3 | 7520 17 MILE RD CEDAR SPRINGS, MI 49319 | AFLAC | $9 | — | $9 | 0.03% |
| DIANNA LYNN ATCHISON3 Filed as: DIANNA ATCHISON | 1839 N WYNDHAM HILL DR NE APT 203 GRAND RAPIDS, MI 49505 | AFLAC | $9 | — | $9 | 0.03% |
| JOSEPH HOFFMAN3 | 1623 CAMINO DE SALMON CORONA, CA 92881 | AFLAC | $9 | — | $9 | 0.03% |
| ARTHUR J QUINN3 | 1643 WENONAH LANE SAGINAW, MI 48603 | AFLAC | $8 | — | $8 | 0.02% |
| JEREMY JAY JOHNSON3 | 7263 BRAXTON DR NOBLESVILLE, IN 46062 | AFLAC | $5 | — | $5 | 0.02% |
| CHARLES D. BLOCK3 Filed as: CHARLES GRAY | 105 DAVENTRY LANE STE 100 LOUISVILLE, KY 40223 | AFLAC | $5 | — | $5 | 0.02% |
| HOWARD R CHISM3 | 235 PENNBROOK TRL BATTLE CREEK, MI 49017 | AFLAC | $5 | — | $5 | 0.02% |
| PHILLIP E WENINO3 Filed as: PHILLIP WENINO | 9117 SPRING VIEW DR STE 202 FORT WAYNE, IN 46804 | AFLAC | $5 | — | $5 | 0.02% |
| RANDALL D LADNER3 Filed as: RANDALL KIMBLER | 678 FRONT AVE NW GRAND RAPIDS, MI 49504 | AFLAC | $3 | — | $3 | 0.01% |
| ANDREW R GRETHEL3 Filed as: ANDREW GRETHEL | 5963 LA PLACE COURT STE 310 CARLSBAD, CA 92008 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN F GLAUB3 | 54369 30TH SOUTH BEND, IN 46635 | AFLAC | $2 | — | $2 | 0.01% |
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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 513 | $4.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 1,014 | $342K |
| Short-term disability | AFLAC | 53 | $33K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 384 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,014 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.