| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S. VANDERVEEN3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD | $55K | — | $55K | 2.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD | — | $1K | $1K | 0.07% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR SE SUTIE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $50K | — | $50K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | ROBERT VANDERVEEN 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $8K | — | $8K | 4.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER D CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 11.08% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESHDA, MD 20814 | VISION SERVICE PLAN | $160 | — | $160 | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVE. SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $333 | — | $333 | 2.48% |
| BRUCE A VAN RYN3 Filed as: BRUCE VANRYN | 3053 RIVERVAL E DRIVE SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $254 | — | $254 | 1.89% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE BENEFITS LLC | 4200 W. MICHIGAN AVE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $114 | — | $114 | 0.85% |
| ASHLEY M. MESSENGER3 Filed as: ASHLEY M MESSENGER | 4200 WEST MICHIGAN AVE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $70 | — | $70 | 0.52% |
| NANETTE JENNINGS3 | 65145 BIG HILL RD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $61 | — | $61 | 0.45% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE M GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $54 | — | $54 | 0.40% |
| TAMARA J YOUNGS3 Filed as: TAMARA YOUNGS | 12045 JENKS ST NE BELDING, MI 48809 | CONTINENTAL AMERICAN INSURANCE COMPANY | $41 | — | $41 | 0.31% |
| WILLIAM JOHNSON & ASSOC LLC3 Filed as: WILLIAM JOHNSON & ASSOC | 1755 INDIAN LAKES CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $35 | — | $35 | 0.26% |
| CHAD SCHWAN3 | 4784 FOREST TRAIL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.19% |
| BENJAMIN HUNTER3 | 11193 GUY ST FISHER, IN 46038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.18% |
| JEFFREY EMERY3 | 34 N. HOWELL ST HILLSDALE, MI 49242 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.13% |
| EDWARD O WALTER III3 Filed as: EDWARD O WALTER | 505 CHERRY STREET APT 309 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.12% |
| JACQUELYN A SULLIVAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.11% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.10% |
| DOUGLAS E FOX3 | 4784 FOREST TRL BELLAIRE, MI 49615 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.08% |
| ROBERT L PARSONS3 | 4130 WEST D AVE KALAMAZOO, MI 49009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.08% |
| KARIE L HOOTMAN3 | PO BOX 99 JONESVILLE, MI 49250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
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 | 201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD | 287 | $3.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 539 | $178K |
| Vision | VISION SERVICE PLAN | 146 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $120K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 26 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $120K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 287 | $1.9M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 539 | — |
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.