| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELIZABETH CASEY3 | 4673 CIDER MILL COURT WALKER, MI 49534 | PRIORITY HEALTH | $32K | $0 | $32K | 2.98% |
| CAROLY HOFSTEE3 | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH | $11K | $0 | $11K | 1.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $5K | $182 | $5K | 6.42% |
| MICHIGAN CHAMBER SERVICES, INC.3 | 600 SOUTH WALNUT STREET LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 1.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | BANK OF AMERICA CHICAGO, IL 60693 | EYEMED | $1K | — | $1K | 8.32% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 257 | $1.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 255 | $79K |
| Vision | EYEMED | 182 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $21K |
| Prescription drug | PRIORITY HEALTH | 257 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.