| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 625 KENMOOR AVENUE SUITE 2004 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $37K | $0 | $37K | 4.38% |
| TGG SOLUTIONS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | $0 | $8K | 1.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $924 | $924 | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 6.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 625 KENMOOR AVENUE SOUTHEAST SUITE 200 GRAND RAPIDS, MI 49546 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 8.59% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 153 | $836K |
| Dental | DELTA DENTAL OF MICHIGAN | 193 | $78K |
| Vision | VISION SERVICE PLAN | 82 | $17K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $61K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $61K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $61K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 153 | $836K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 110 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.