| 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 | $11K | $26K | $37K | 11.83% |
| SCOTT SETTLE3 Filed as: SCOTT E. BLOEM | 3055 44TH ST SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $765 | $5K | 10.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Float revenue; Insurance services; Non-monetary compensation; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Direct payment from the plan; Consulting (general) Service code 12 | — | $166K |
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 | 206 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $313K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $47K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $47K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $47K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $313K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 171 | $313K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.