| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $43K | $1K | $45K | 2.33% |
| ROBERT S. VANDERVEEN3 | 1591 GALBRAITH AVENUE SE MICHIGAN, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $14K | $0 | $14K | 0.73% |
| ANDREW L. DISSELKOEN3 | 1591 GALBRAITH AVENUE SE CASCADE, MI 49546 | PRIORITY HEALTH | $38K | $0 | $38K | 2.63% |
| ROBERT S. VANDERVEEN3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $24K | $0 | $24K | 1.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $9K | $0 | $9K | 4.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $0 | $11K | 8.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 4.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | VISON SERVICE PLAN | $1K | $0 | $1K | 4.65% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISON SERVICE PLAN | $140 | $0 | $140 | 0.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST, LTD | 55 EAST JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $119 | $0 | $119 | 2.49% |
| MEAGAN SMITH3 | 50 WEST ALDEN AVENUE BATTLE CREEK, MI 49014 | CONTINENTAL AMERICAN INSURANCE COMPANY | $105 | $0 | $105 | 2.20% |
| BRUCE A VAN RYN3 Filed as: BRUCE ALBERT VAN RYN | 3053 RIVERVALE DRIVE GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $86 | $0 | $86 | 1.80% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE BENEFITS, LLC | 4200 WEST MICHIGAN AVENUE KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 0.63% |
| NANETTE JENNINGS3 Filed as: NANETTE SUE JENNINGS | 65145 NORTH BIG HILL ROAD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | $0 | $22 | 0.46% |
| ASHLEY M. MESSENGER3 Filed as: ASHLEY MARIE MENDENHALL | 41 26TH STREET NORTH BATTLE CREEK, MI 49015 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | $0 | $19 | 0.40% |
| CASSIE MARIE GOODBAND3 | 4623 ROMENCE PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | $0 | $19 | 0.40% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 277 | $3.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 558 | $199K |
| Vision | VISON SERVICE PLAN | 159 | $30K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 203 | $130K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 203 | $130K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 277 | $3.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 203 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 558 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.