| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $42K | $0 | $42K | 3.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CARE NETWORK OF MICHIGAN | $0 | $938 | $938 | 0.08% |
| MARC J LASCESKI3 Filed as: MARC J. LASCESKI | 1100 SUPERIOR AVENUE SUITE 1500 CLEVELAND, OH 44114 | BLUE CARE NETWORK OF MICHIGAN | $828 | $0 | $828 | 0.07% |
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $6K | $0 | $6K | 3.54% |
| MARC J LASCESKI3 Filed as: MARC J. LASCESKI | 1100 SUPERIOR AVENUE SUITE 1500 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $132 | $0 | $132 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $94 | $94 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST UNLIMITED | 55 EAST JACKSON CHICAGO, IL 60604 | AETNA LIFE INSURANCE COMPANY | $10K | $126 | $10K | 10.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $2K | $11K | 12.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST UNLIMITED | 55 EAST JACKSON CHICAGO, IL 60604 | FSL | $1K | $0 | $1K | 7.65% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVENUE SUITE 1500 CLEVELAND, OH 44114 | FSL | $341 | $0 | $341 | 2.35% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 193 | $1.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 272 | $93K |
| Vision | FSL | 241 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $92K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $92K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $92K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 193 | $1.3M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 252 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.