| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LINNEA L. HOEKWATER3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $42K | — | $42K | 2.72% |
| SUSAN L CULHANE3 | 5579 STADIUM DRIVE KALAMAZOO, MA 49009 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $4K | — | $4K | 0.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.86% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, LLC | 5579 STADIUM DR KALAMAZOO, MI 49009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $359 | — | $359 | 1.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 12.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $844 | $844 | 5.02% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, LLC | 5579 STADIUM DR KALAMAZOO, MA 49009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $419 | — | $419 | 2.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 12.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $828 | $828 | 5.15% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, LLC | 5579 STADIUM DR KALAMAZOO, MI 49009 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $362 | — | $362 | 2.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASR HEALTH BENEFITS EIN 38-2651185 THIRD PARTY ADMINISTRATI | Contract Administrator Service code 13 | — | $7K |
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 203 | $1.5M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 203 | $1.5M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $16K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 203 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.