| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | $44K | — | $44K | 1.29% |
| 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 | $114K | — | $114K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $10K | — | $10K | 2.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE. SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 2.49% |
| BRUCE A VAN RYN3 Filed as: BRUCE VANRYN | 3053 RIVERVAL E DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.95% |
| WORKSTIE BENEFITS LLC3 | 4200 W. MICHIGAN AVE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $504 | — | $504 | 0.81% |
| TAMERA YOUNGS3 | 12045 JENKS ST NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $270 | — | $270 | 0.43% |
| WILLIAM JOHNSON3 | 17276 VIOLET RUTH DRIVE CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $249 | — | $249 | 0.40% |
| EDWARD O WALTER III3 Filed as: EDWARD O WALTER | 505 CHERRY STREET APT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $158 | — | $158 | 0.25% |
| CHAD SCHWAN3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $126 | — | $126 | 0.20% |
| JEFFREY EMERY3 | 34 N. HOWELL ST HILLSDALE, MI 49242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $109 | — | $109 | 0.18% |
| CM FORTADO INC3 Filed as: CM FORTADO INC. | 1755 EA 2549 PALM DAST PLUMB LANE WYOMING, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $102 | — | $102 | 0.16% |
| NANETTE JENNINGS3 | 65145 BIG HILL RD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $98 | — | $98 | 0.16% |
| JACQUELYN A SULLIVAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $98 | — | $98 | 0.16% |
| EL TORRO INC3 Filed as: EL TORRO INC. | 2549 PALM DALE DR SW WYOMING, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $91 | — | $91 | 0.15% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE E GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | — | $87 | 0.14% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.09% |
| DOUGLAS E FOX3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | — | $53 | 0.09% |
| MICHELLE ASHLEY3 | PO BOX 23 STEVENSVILLE, MI 49127 | CONTINENTAL AMERICAN INSURANCE COMPANY | $51 | — | $51 | 0.08% |
| KARIE L HOOTMAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 0.07% |
| ASHELY M MESSENGER3 | 4200 WEST MICHIGAN AVE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34 | — | $34 | 0.05% |
| BETH SOMMERS3 | 3181 SHAHUCK ROAD SAGINAW, MI 48603 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.05% |
| CYNTHIA LERNER RUBIN3 Filed as: CYNTHIA J LANGER | UNKNOWN UNKNOWN, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.05% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHER, IN 46038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.04% |
| RICHARD SOMMERS3 | 1830 HANDLEY ST SAGINAW, MI 48602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER D CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTIONS CENTER DR GRAND RAPIDS, MI 49546 | VISION SERVICE PLAN | $2K | — | $2K | 3.76% |
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 | 379 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 580 | $6.3M |
| Dental | DELTA DENTAL OF MICHIGAN | 1,047 | $372K |
| Vision | VISION SERVICE PLAN | 282 | $49K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 170 | $62K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 167 | $57K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 580 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,047 | — |
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.