| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT SETTLE3 Filed as: SCOTT E BLOEM | 3055 44TH ST SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $37K | $53K | 12.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. | 3055 44TH ST SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AG | 3055 44TH ST SW GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 7.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AG | 3055 44TH ST SW GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 18.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Float revenue; Consulting (general); Claims processing; Non-monetary compensation; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Insurance services; Other fees Service code 12 | — | $212K |
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 | 301 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 301 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 176 | $436K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 176 | $436K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 176 | $436K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $163K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $109K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $109K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 176 | $436K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 176 | $436K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.