| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BLOEM3 | 3055 44TH STREET SW GRANDVILLE, MI 49418 | PRIORITY HEALTH | $38K | $0 | $38K | 4.09% |
| SCOTT BLOEM3 | 3055 44TH STREET SW GRANDVILLE, MI 49418 | PHYSICIANS HEALTH PLAN | $4K | $0 | $4K | 4.00% |
| SCOTT BLOEM3 | 3055 44TH STREET SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | $0 | $8K | 9.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $590 | $590 | 0.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | VISION SERVICE PLAN | $821 | $0 | $821 | 6.68% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEORGETWON ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $60 | $0 | $60 | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $962 | $309 | $1K | 11.69% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 184 | $1.0M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 218 | $83K |
| Vision | VISION SERVICE PLAN | 89 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 31 | $50K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 31 | $50K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 184 | $1.0M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.