| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN,STEVEN,RAY | SUITE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $124 | $5K | 3.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICK STUIT | PO BOX 953 GRANDVILLE, MI 49468 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 2.37% |
| TITAN BENEFIT COMMUNICATIONS LLC3 | 504 EAST 4TH STREET ROYAL OAK, MI 48067 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $809 | — | $809 | 0.51% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN,STEVEN,RAY | SUITE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $304 | $9K | 6.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT | PO BOX 953 GRANDVILLE, MI 49468 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $5K | $15K | 11.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | PO BOX 953 GRANDVILLE, MI 494680953 | EYE MED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | $9K | — | $9K | 9.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $7K | 8.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $768 | $4K | 15.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Float revenue; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Insurance services; Contract Administrator; Claims processing Service code 12 | — | $415K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $31K |
| BERENDS HENDRICKS STUIT | Insurance brokerage commissions and fees; Non-monetary compensation; Insurance agents and brokers; Other fees; Other commissions Service code 22 | — | $27K |
| STEVE OLSON | Other fees; Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation; Other commissions Service code 22 | — | $5K |
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 | 799 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYE MED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,224 | $95K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,104 | $375K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 621 | $312K |
| Long-term disability(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 621 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,224 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.