| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD | $43K | — | $43K | 1.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD | — | $2K | $2K | 0.06% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUTIE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $102K | — | $102K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $11K | $844 | $12K | 3.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER D CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 9.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE. SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.65% |
| BRUCE A VAN RYN3 Filed as: BRUCE VANRYN | 3053 RIVERVAL E DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.99% |
| ASHELY M MESSENGER3 | 4200 WEST MICHIGAN AVE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.93% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE BENEFITS LLC | 4200 W. MICHIGAN AVE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $450 | — | $450 | 0.75% |
| TAMARA J YOUNGS3 Filed as: TAMARA YOUNGS | 12045 JENKS ST NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $241 | — | $241 | 0.40% |
| WILLIAM JOHNSON & ASSOC LLC3 Filed as: WILLIAM JOHNSON & ASSOC | 1755 INDIAN LAKES CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $222 | — | $222 | 0.37% |
| EDWARD O WALTER III3 Filed as: EDWARD O WALTER | 505 CHERRY STREET APT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $144 | — | $144 | 0.24% |
| CHAD SCHWAN3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $125 | — | $125 | 0.21% |
| CM FORTADO INC3 Filed as: CM FORTADO INC. | 5316 ARLINGTON CIR HANOVER PARK, IL 60133 | CONTINENTAL AMERICAN INSURANCE COMPANY | $97 | — | $97 | 0.16% |
| NANETTE JENNINGS3 | 65145 BIG HILL RD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $93 | — | $93 | 0.15% |
| JEFFREY EMERY3 | 34 N. HOWELL ST HILLSDALE, MI 49242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $90 | — | $90 | 0.15% |
| JACQUELYN A SULLIVAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | — | $87 | 0.14% |
| EL TORRO INC3 Filed as: EL TORRO INC. | 2549 PALM DALE DR SW WYOMING, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | — | $87 | 0.14% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE E GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $82 | — | $82 | 0.14% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 0.09% |
| DOUGLAS E FOX3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | — | $53 | 0.09% |
| ROBERT L PARSONS3 | 4130 WEST D AVE KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.08% |
| KARIE L HOOTMAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.07% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHER, IN 46038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.04% |
| BETH SOMMERS3 | 1390 WEST BLVD BERKLEY, MI 48072 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| MICHELLE ASHLEY3 | PO BOX 293 STEVENSVILLE, MI 49127 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| CYNTHIA LERNER RUBIN3 Filed as: CYNTHIA J LANGER | UNKNOWN UNKNOWN, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| RICHARD SOMMERS3 | 1390 WEST BLVD BERKLEY, MI 48072 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | VISION SERVICE PLAN | $2K | — | $2K | 3.52% |
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 | 383 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 570 | $5.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 1,043 | $357K |
| Vision | VISION SERVICE PLAN | 293 | $55K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 170 | $60K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 394 | $65K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 570 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,043 | — |
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.