| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUG CALKINS3 | 56 GRANDVILLE AVENUE SW SUITE 300 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $28K | $0 | $28K | 2.43% |
| DOUGLAS WILLIAM JR NAGEL3 | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $9K | $0 | $9K | 0.79% |
| 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 | $2K | $2K | 0.14% |
| DOUG CALKINS3 | 56 GRANDVILLE AVENUE SW SUITE 300 GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $4K | $0 | $4K | 2.10% |
| DOUGLAS WILLIAM JR NAGEL3 | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $2K | $0 | $2K | 1.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $0 | $293 | $293 | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON CHICAGO, IL 60604 | DEARBORN LIFE INSURANCE COMPANY | $10K | $4K | $14K | 18.38% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 278 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 278 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 278 | $1.1M |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 173 | $74K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 173 | $74K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 173 | $74K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 278 | $1.3M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 173 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.