| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH | $107K | $0 | $107K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42K | $0 | $42K | 15.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF IN LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 2.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SOUTHEAST GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $6K | $0 | $6K | 3.00% |
| ANJA HARMON3 | 16253 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH INSURANCE COMPANY | $3K | $0 | $3K | 3.00% |
| CATHERINE MICHELLE DOBRATZ3 Filed as: CATHERINE M. DOBRATZ | 9903 EAST 150TH AVENUE BRIGHTON, CO 80602 | UNUM INSURANCE COMPANY | $13K | $0 | $13K | 17.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM INSURANCE COMPANY | $7K | $384 | $7K | 9.27% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 9903 EAST 150TH AVENUE BRIGHTON, CO 80602 | UNUM INSURANCE COMPANY | $1K | $0 | $1K | 1.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF IN LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM INSURANCE COMPANY | $0 | $457 | $457 | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MD 49501 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.89% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $229 | $0 | $229 | 0.50% |
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 | 323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 626 | $3.7M |
| Dental | DELTA DENTAL OF MICHIGAN | 700 | $211K |
| Vision | VISION SERVICE PLAN | 274 | $46K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $260K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $260K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $260K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 626 | $3.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 325 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 700 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.