| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BLOEM3 | 3055 44TH ST SW GRANDVILLE, MI 49418 | PRIORITY HEALTH | $35K | $0 | $35K | 3.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, IL 49418 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $3K | $11K | 13.16% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $834 | $3K | 3.40% |
| SCOTT BLOEM3 | 3055 44TH ST SW GRANDVILLE, MI 49418 | PHYSICIANS HEALTH PLAN | $3K | $0 | $3K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 12.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | VISION SERVICE PLAN | $753 | $0 | $753 | 7.20% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEORGTOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $51 | $0 | $51 | 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 | $842 | $154 | $996 | 13.96% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 183 | $942K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 210 | $83K |
| Vision | VISION SERVICE PLAN | 82 | $10K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 104 | $7K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 33 | $31K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 33 | $31K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 183 | $942K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 104 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.