| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICK D DALTON3 | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CARE NETWORK OF MICHIGAN | $28K | $0 | $28K | 2.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49419 | BLUE CARE NETWORK OF MICHIGAN | $0 | $617 | $617 | 0.06% |
| PATRICK D DALTON3 | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $3K | $0 | $3K | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49419 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $0 | $79 | $79 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | PO BOX 953 GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $10K | $620 | $11K | 10.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49419 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 15.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | PO BOX 953 GRANDVILLE, MI 49468 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE CO. | $980 | $0 | $980 | 10.07% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 200 | $1.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 313 | $103K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE CO. | 312 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $68K |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 158 | $197K |
| Long-term disability(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 158 | $197K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 200 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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.