| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BLOEM3 | 3055 44TH STREET GRANDVILLE, MI 494180295 | PRIORITY HEALTH | $70K | — | $70K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | SCOTT BLOEM 3055 44TH ST SW GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 6.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | STANDARD INSURANCE COMPANY | $8K | $1K | $9K | 17.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | STANDARD INSURANCE COMPANY | $7K | $971 | $8K | 17.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | STANDARD INSURANCE COMPANY | $4K | $612 | $5K | 17.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | VISION SERVICE PLAN | $832 | — | $832 | 6.76% |
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 | 147 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 356 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 168 | $64K |
| Vision | VISION SERVICE PLAN | 69 | $12K |
| Life insurance | STANDARD INSURANCE COMPANY | 147 | $55K |
| Short-term disability | STANDARD INSURANCE COMPANY | 147 | $45K |
| Long-term disability | STANDARD INSURANCE COMPANY | 147 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 356 | — |
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.