| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUG CALKINS3 | 625 KENMOOR AVENUE SOUTHEAST S200 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $30K | $0 | $30K | 3.67% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $310 | $0 | $310 | 0.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 625 KENMOOR AVENUE, SUITE 200 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $253 | $253 | 0.03% |
| DOUG CALKINS3 | 625 KENMOOR AVENUE SOUTHEAST, S200 GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $11K | $0 | $11K | 3.80% |
| GROTENHUIS3 | PO BOX 140167 GRAND RAPIDS, MI 49514 | BLUE CARE NETWORK OF MICHIGAN | $2K | $0 | $2K | 0.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 625 KENMOOR AVENUE, SUITE 200 GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $0 | $179 | $179 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $7K | $12K | 31.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTIONS CENTER DRIVE 40 WEST MADISON 4TH FLOOR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $757 | $6K | 17.64% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | VISION SERVICE PLAN | $831 | $0 | $831 | 6.77% |
| DAVID SCHWARTZ3 Filed as: DAVID F SCHWARTZ | 6444 MORELAND ROAD JONESVILLE, MI 49250 | AFLAC | $276 | $26 | $302 | 3.88% |
| CONNIE RUPERT3 Filed as: CONNIE M RUPERT | 180 WEST MICHIGAN AVENUE, SUITE 300 JACKSON, MI 49201 | AFLAC | $247 | $41 | $288 | 3.70% |
| MJ INSURANCE3 Filed as: BECKY S WAREHAM AND VARIOUS AGENTS | 660 BLOSSOM ROAD ATHENS, MI 49011 | AFLAC | $242 | $32 | $274 | 3.52% |
| KARIE LYNN HOOTMAN3 | 34 NORTH HOWELL STREET HILLSDALE, MI 49242 | AFLAC | $230 | $28 | $258 | 3.31% |
| ELIZABETH ELAINE HENDERSHOT3 | 6764 KING ROAD SPRING ARBOR, MI 49283 | AFLAC | $175 | $27 | $202 | 2.59% |
| DAVID SCHWARTZ3 | PO BOX 99 JONESVILLE, MI 49250 | AFLAC | $131 | $0 | $131 | 1.68% |
| HOLLY JEAN ROSSNER3 | 9755 MAINES ROAD PARMA, MI 49269 | AFLAC | $121 | $0 | $121 | 1.55% |
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 | 216 | 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) | 216 | 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 | 175 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 175 | $830K |
| Vision | VISION SERVICE PLAN | 100 | $12K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 261 | $73K |
| Short-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 261 | $80K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 261 | $73K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 175 | $1.1M |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 364 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 364 | — |
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.