| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICK D DALTON3 Filed as: PATRICK D. DALTON | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CARE NETWORK OF MICHIGAN | $42K | $0 | $42K | 4.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | BLUE CARE NETWORK OF MICHIGAN | $0 | $672 | $672 | 0.08% |
| PATRICK D DALTON3 Filed as: PATRICK D. DALTON | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $19K | $0 | $19K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | $0 | $290 | $290 | 0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 7000 VISTA DE ORO DRIVE NE ROCKFORD, MI 49341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 10.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 4.17% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDSVILLE, MI 49468 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $175 | $0 | $175 | 1.81% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 105 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $142K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 212 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $142K |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 123 | $563K |
| Long-term disability(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MICHIGAN | 123 | $563K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 105 | $1.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.