| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROXANNA DIETERLE3 | 300 OTTAWA, SUITE 300 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $31K | $0 | $31K | 2.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 30150 TELEGRAPH ROAD, SUITE 408 BINGHAM FARMS, MI 48025 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $2K | $8K | 11.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$1 | -$1 | -$2 | -0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2401 WEST BIG BEAVER, SUITE 400 TROY, MI 48083 | DELTA DENTAL OF MICHIGAN | $4K | $0 | $4K | 5.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF MICHIGAN | $254 | $0 | $254 | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 55 EAST JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 OTTAWA AVENUE NW, SUITE 301 GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.10% |
| MICHIGAN CHAMBER SERVICES, INC.3 | 600 SOUTH WALNUT STREET LANSING, MI 48933 | VISION SERVICE PLAN | $2K | $0 | $2K | 13.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $589 | $0 | $589 | 4.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 OTTAWA AVENUE NW, SUITE 301 GRAND RAPIDS, MI 49503 | GERBER LIFE INSURANCE COMPANY | $232 | $0 | $232 | 13.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE, SUITE 200 GRAND RAPIDS, MI 49546 | GERBER LIFE INSURANCE COMPANY | $22 | — | $22 | 1.30% |
| UNKNOWN3 | UNKNOWN CEDAR SPRINGS, MI 49319 | TELADOC HEALTH | $64 | $0 | $64 | 14.00% |
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 | 236 | 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) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 182 | $1.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 187 | $64K |
| Vision | VISION SERVICE PLAN | 90 | $12K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $74K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $74K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $94K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 182 | $1.2M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.