| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | $46K | — | $46K | 1.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | — | $2K | $2K | 0.07% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUTIE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $96K | — | $96K | 3.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $11K | — | $11K | 3.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE. SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27K | — | $27K | 34.84% |
| TAMERA YOUNGS3 | 12045 JENKS ST NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 7.01% |
| BRUCE A VAN RYN3 Filed as: BRUCE VANRYN | 3053 RIVERVAL E DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 6.91% |
| CHAD SCHWAN3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 3.77% |
| JEFFREY EMERY3 | 34 N. HOWELL ST HILLSDALE, MI 49242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 3.51% |
| CM FORTADO INC3 Filed as: CM FORTADO INC. | 1755 EA 2549 PALM DAST PLUMB LANE WYOMING, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.61% |
| NANETTE JENNINGS3 | 65145 BIG HILL RD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.48% |
| MICHELLE ASHLEY3 | PO BOX 23 STEVENSVILLE, MI 49127 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.88% |
| WORKSTIE BENEFITS LLC3 | 4200 W. MICHIGAN AVE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.68% |
| BETH SOMMERS3 | 3181 SHAHUCK ROAD SAGINAW, MI 48603 | CONTINENTAL AMERICAN INSURANCE COMPANY | $442 | — | $442 | 0.58% |
| WILLIAM JOHNSON3 | 17276 VIOLET RUTH DRIVE CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $437 | — | $437 | 0.57% |
| EDWARD O WALTER III3 Filed as: EDWARD O WALTER | 505 CHERRY STREET APT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $346 | — | $346 | 0.45% |
| JACQUELYN A SULLIVAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $209 | — | $209 | 0.27% |
| EL TORRO INC3 Filed as: EL TORRO INC. | 2549 PALM DALE DR SW WYOMING, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $155 | — | $155 | 0.20% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $148 | — | $148 | 0.19% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE E GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $144 | — | $144 | 0.19% |
| DOUGLAS E FOX3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $134 | — | $134 | 0.17% |
| KARIE L HOOTMAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $122 | — | $122 | 0.16% |
| CYNTHIA LERNER RUBIN3 Filed as: CYNTHIA J LANGER | UNKNOWN UNKNOWN, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $114 | — | $114 | 0.15% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHER, IN 46038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $64 | — | $64 | 0.08% |
| RICHARD SOMMERS3 | 1830 HANDLEY ST SAGINAW, MI 48602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER D CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $7K | 13.06% |
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 | 370 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 537 | $5.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 955 | $335K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 165 | $77K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 384 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 955 | — |
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.