| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUG CALKINS3 | 625 KENMOOR AVENUE, SUITE S200 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $24K | $0 | $24K | 2.95% |
| 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 | $993 | $993 | 0.12% |
| DOUG CALKINS3 | 625 KENMOOR AVENUE, SUITE S200 GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $9K | $0 | $9K | 2.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 2167 GRAND RAPIDS, MI 49501 | BLUE CARE NETWORK OF MICHIGAN | $0 | $437 | $437 | 0.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTION CENTER DRIVE 40W MADISON, 4TH FLOOR BOFA CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $554 | $5K | 14.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | VISION SERVICE PLAN | $817 | $0 | $817 | 6.87% |
| KARIE LYNN HOOTMAN3 Filed as: KARIE HOOTMAN | 34 NORTH HOWELL STREET HILLSDALE, MI 49242 | AFLAC | $520 | $13 | $533 | 7.56% |
| CONNIE RUPERT3 | 3201 EAST MICHICAN AVENUE SUITE 109 JACKSON, MI 49202 | AFLAC | $132 | $0 | $132 | 1.87% |
| DAVID SCHWARTZ3 | 6444 MORELAND ROAD JONESVILLE, MI 49250 | AFLAC | $53 | $20 | $73 | 1.04% |
| JACQUELYN A SULLIVAN3 Filed as: JACQUELYN SULLIVAN | 34 NORTH HOWELL STREET HILLSDALE, MI 49242 | AFLAC | $67 | $1 | $68 | 0.96% |
| RONALD DASHKOVITZ AND OTHER AGENTS3 Filed as: RONALD DASHKOVITZ & VARIOUS AGNTS | 139 WEST LAKE LANSING ROAD SUITE 200 EAST LANSING, MI 48823 | AFLAC | $44 | $8 | $52 | 0.74% |
| MICHELLE J HALLER3 Filed as: MICHELLE CALVIN | PO BOX 99 JONESVILLE, MI 49250 | AFLAC | $48 | $0 | $48 | 0.68% |
| ELIZABETH ELAINE HENDERSHOT3 Filed as: ELIZABETH HENDERSHOT | 6764 KING ROAD SPRING ARBOR, MI 49283 | AFLAC | $34 | $0 | $34 | 0.48% |
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 | 369 | 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) | 369 | 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 | 135 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $817K |
| Vision | VISION SERVICE PLAN | 89 | $12K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 230 | $36K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 230 | $43K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 230 | $36K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 135 | $1.1M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 340 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.