| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAPNICK & COMPANY, INC.3 Filed as: KAPNICK AND COMPANY, INC. | 333 INDUSTRIAL DRIVE ADRIAN, MI 49221 | VISION SERVICE PLAN | $4K | $0 | $4K | 0.25% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43603 | VISION SERVICE PLAN | $869 | $0 | $869 | 0.06% |
| GALLIGHER BENEFIT SERVICES OF MI3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $578 | $0 | $578 | 0.04% |
| SAGINAW BAY UNDERWRITERS3 | 1258 SOUTH WASHINGTON AVENUE SAGINAW, MI 48601 | VISION SERVICE PLAN | $259 | $0 | $259 | 0.02% |
| E.A. BECKER & ASSOCIATES INC3 Filed as: E.A. BECKER AND ASSOCIATES INC. | PO BOX 5619 SAGINAW, MI 48603 | VISION SERVICE PLAN | $117 | $0 | $117 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF DETROIT | PO BOX 746567 ATLANTA, GA 30374 | VISION SERVICE PLAN | -$11 | $0 | -$11 | -0.00% |
| MICHELLE M. SHUART3 | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $50K | $0 | $50K | 4.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $1K | $1K | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $3K | $78 | $4K | 3.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 1.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVENUE, SUITE 750 WINTER PARK, FL 32789 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 9.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9200 WARD PARKWAY, SUITE 500 KANSAS CITY, MO 64114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $401 | $0 | $401 | 3.77% |
| ASHLEY M. MESSENGER3 | 4200 WEST MICHIGAN AVENUE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $187 | $0 | $187 | 1.76% |
| CASSIE MARIE GOODBAND3 Filed as: CASSIE M. GOODBAND | 4623 ROMENCE ROAD PORTAGE, MI 49024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $97 | $0 | $97 | 0.91% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE BENEFITS LLC | 4200 WEST MICHIGAN AVENUE SUITE 102 KALAMAZOO, MI 49006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | $0 | $40 | 0.38% |
| NANETTE JENNINGS3 Filed as: NANETTE S. JENNINGS | 65145 BIG HILL ROAD STURGIS, MI 49091 | CONTINENTAL AMERICAN INSURANCE COMPANY | $37 | $0 | $37 | 0.35% |
| MJ INSURANCE3 Filed as: SARAH MEANY AND VARIOUS AGENTS | 2710 HAMPSHIRE BOULEVARD SE GRAND RAPIDS, MI 49506 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | $0 | $10 | 0.09% |
| EL TORRO INC3 Filed as: EL TORRO INC. | UNKNOWN LUDINGTON, MI 49431 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | $0 | $7 | 0.07% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 197 | $1.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 249 | $104K |
| Vision | VISION SERVICE PLAN | 0 | $1.4M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $77K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $88K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $77K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 197 | $1.0M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.