| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD | $48K | — | $48K | 2.95% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUTIE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $56K | — | $56K | 4.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONA MIDWEST LIMITED | ROBERT VANDERVEEN 55 E JACKSON BLVD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 2.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ROBERT VANDERVEEN 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 1.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER D CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $1K | $6K | 12.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 2167 GRAND RAPIDS, MI 49546 | VISION SERVICE PLAN | $1K | — | $1K | 4.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE. SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $187 | — | $187 | 1.13% |
| BRUCE A VAN RYN3 Filed as: BRUCE VANRYN | 3053 RIVERVAL E DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $142 | — | $142 | 0.86% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE BENEFITS LLC | 4200 W. MICHIGAN AVE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.39% |
| ASHLEY M. MESSENGER3 Filed as: ASHLEY M MESSENGER | 4200 WEST MICHIGAN AVE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.24% |
| NANETTE JENNINGS3 | 65145 BIG HILL RD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34 | — | $34 | 0.21% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE M GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.18% |
| TAMARA J YOUNGS3 Filed as: TAMARA YOUNGS | 12045 JENKS ST NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | — | $25 | 0.15% |
| WILLIAM JOHNSON & ASSOC LLC3 Filed as: WILLIAM JOHNSON & ASSOC | 1755 INDIAN LAKES CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | — | $22 | 0.13% |
| CHAD SCHWAN3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.08% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHER, IN 46038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.08% |
| EDWARD O WALTER III3 Filed as: EDWARD O WALTER | 505 CHERRY STREET APT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.06% |
| JEFFREY EMERY3 | 34 N. HOWELL ST HILLSDALE, MI 49242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.05% |
| JACQUELYN A SULLIVAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.04% |
| DOUGLAS E FOX3 | 4784 FOREST TRL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| ROBERT L PARSONS3 | 4130 WEST D AVE KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| KARIE L HOOTMAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.02% |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 282 | $3.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 538 | $182K |
| Vision | VISION SERVICE PLAN | 138 | $28K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 48 | $17K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 282 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 538 | — |
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."
No prospect flags tripped on this filing.