| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH | $68K | $0 | $68K | 4.09% |
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 5.30% |
| JASON RUSSELL3 Filed as: JASON RUSSLL | 600 SOUTH WALNUT STREET LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 1.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 4830 WEST KENNEDY BOULEVARD SUITE 850 TAMPA, FL 33609 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 6.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATONAL MIDWEST LIMITED | PO BOX 2167 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 11.80% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 291 | $1.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 290 | $97K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 244 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $57K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $57K |
| Prescription drug | PRIORITY HEALTH | 291 | $1.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.