| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49468 | PRIORITY HEALTH | $27K | $0 | $27K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $3K | $119 | $3K | 8.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $821 | $4K | 17.17% |
| LEANN P DAVIDSON3 Filed as: LEANN P. DAVIDSON | 204 WEST SKEELS ROAD MONTAGUE, MI 49437 | AFLAC | $477 | $0 | $477 | 4.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | AFLAC | $289 | $0 | $289 | 2.59% |
| MJ INSURANCE3 Filed as: ERIC J. CONDRON AND VARIOUS AGENTS | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | AFLAC | $257 | $26 | $283 | 2.53% |
| SARAH E MEANY3 Filed as: SARAH E. MEANY | 4000 PORTAGE STREET, SUITE 109 KALAMAZOO, MI 49001 | AFLAC | $184 | $34 | $218 | 1.95% |
| WILLIAM DAVID BARHAM3 | 2039 RAMBLING OAK DRIVE MUSKEGON, MI 49445 | AFLAC | $122 | $0 | $122 | 1.09% |
| LAURA ANN DILLIVAN3 | 1545 COLE AVENUE NE GRAND RAPIDS, MI 49505 | AFLAC | $60 | $0 | $60 | 0.54% |
| ANDREW K GLAUB3 Filed as: ANDREW K. GLAUB | PO BOX 339 BELLAIRE, MI 49615 | AFLAC | $39 | $0 | $39 | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $627 | $0 | $627 | 10.10% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 132 | $675K |
| Dental | DELTA DENTAL OF MICHIGAN | 112 | $37K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 110 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $22K |
| Short-term disability | AFLAC | 12 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $22K |
| Prescription drug | PRIORITY HEALTH | 132 | $675K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.