| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH | $27K | $0 | $27K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | $0 | $23K | 14.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $8K | $351 | $8K | 5.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | $0 | $13K | 15.30% |
| ANJA HARMON3 | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH INSURANCE COMPANY | $226 | $0 | $226 | 2.00% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 394 | $1.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 405 | $146K |
| Vision | VISION SERVICE PLAN | 124 | $20K |
| Life insurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $247K |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $247K |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $247K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 394 | $1.4M |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 405 | — |
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.