| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $6K | $17K | 12.04% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN, STEVE, RAY | SUITE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.00% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN, STEVE, RAY | SUITE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.23% |
| TITAN BENEFIT COMMUNICATIONS LLC3 | 504 EAST 4TH ST ROYAL OAK, MI 48067 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $496 | — | $496 | 0.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | PO BOX 953 GRANDVILLE, MI 494680953 | EYEMED VISION CARE C/O FIDELITY SECURITY LIFE INSURANCE COMPANY | $10K | — | $10K | 10.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 10.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 15.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Consulting (general); Direct payment from the plan; Contract Administrator; Float revenue; Other fees Service code 12 | 600 LAFAYETTE E DETROIT, MI 48226 | $500K |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 4100 OKEMOS ROAD OKEMOS, MI 48864 | $28K |
| STEVE OLSON | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other fees; Other commissions Service code 22 | — | $28K |
| BERENDS HENDRICKS STUIT | Non-monetary compensation; Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees; Other fees Service code 22 | — | $11K |
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 | 737 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 737 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 882 | $320K |
| Short-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 882 | $297K |
| Long-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $250K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,234 | — |
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.