| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL DAVID HORNING3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN MUTUAL | $18K | $8K | $27K | 15.19% |
| RYAN JAMES GOLDMAN3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN MUTUAL | $2K | $3K | $5K | 2.73% |
| WESTERN MI GROUP LLC3 Filed as: WESTERN MI GROUP, LLC | 55 CAMPAU AVENUE NW, SUITE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | $2K | $139 | $2K | 0.98% |
| R. GEORGE DE VRIES3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN MUTUAL | -$1 | — | -$1 | -0.00% |
| GORDON ELGERSMA3 | 85 CAMPAU AVENUE NW GRAND RAPIDS, MI 49503 | NORTHWESTERN MUTUAL | -$10 | -$1 | -$11 | -0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 11.71% |
| PATRICK R. COLEMAN3 Filed as: PATRICK COLEMAN | 5380 CASCADE ROAD SE, SUITE 300 GRAND RAPIDS, MI 49546 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 3.29% |
| DANIEL DAVID HORNING3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN LONG TERM CARE INSURANCE COMPANY | $2K | $2K | $4K | 5.03% |
| WESTERN MI GROUP LLC3 Filed as: WESTERN MI GROUP, LLC | 55 CAMPAU AVENUE NW, SUITE 400 GRAND RAPIDS, MI 49503 | NORTHWESTERN LONG TERM CARE INSURANCE COMPANY | $560 | $49 | $609 | 0.76% |
| R. GEORGE DE VRIES3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN LONG TERM CARE INSURANCE COMPANY | $214 | $48 | $262 | 0.33% |
| RYAN JAMES GOLDMAN3 | 12 WASHINGTON AVENUE, SUITE 200 GRAND HAVEN, MI 49417 | NORTHWESTERN LONG TERM CARE INSURANCE COMPANY | — | $173 | $173 | 0.22% |
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 | 324 | 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) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $138K |
| Long-term disability(2 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 324 | $313K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.