| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RYAN ROOT3 | 3055 44TH STREET SW GRANDVILLE, MI 49418 | PRIORITY HEALTH | $28K | $0 | $28K | 3.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49468 | DELTA DENTAL OF MICHIGAN | $3K | $41 | $3K | 7.85% |
| BENEFIT PROFILES INC3 Filed as: BENEFIT PROFILES, INC. | 500 CASCADE WEST PARKWAY GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | 3055 44TH STREET SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $572 | $3K | 12.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $790 | $277 | $1K | 4.31% |
| LEANN P DAVIDSON3 Filed as: LEANN P. DAVIDSON | 204 WEST SKEELS ROAD MONTAGUE, MI 49437 | AFLAC | $366 | $0 | $366 | 4.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49418 | AFLAC | $292 | $0 | $292 | 3.23% |
| SARAH E MEANY3 Filed as: SARAH E. MEANY | 4000 PORTAGE STREET, SUITE 109 KALAMAZOO, MI 49001 | AFLAC | $204 | $0 | $204 | 2.26% |
| MJ INSURANCE3 Filed as: MONICA MILLER AND VARIOUS AGENTS | 675 PRESERVE CIRCLE DRIVE SE APARTMENT 3 GRAND RAPIDS, MI 49548 | AFLAC | $136 | $0 | $136 | 1.50% |
| WILLIAM DAVID BARHAM3 | 2039 RAMBLING OAK DRIVE MUSKEGON, MI 49445 | AFLAC | $112 | $0 | $112 | 1.24% |
| LAURA ANN DILLIVAN3 | 1545 COLE AVENUE NE GRAND RAPIDS, MI 49505 | AFLAC | $54 | $0 | $54 | 0.60% |
| ANDREW K GLAUB Filed as: ANDREW K. GLAUB | PO BOX 339 BELLAIRE, MI 49615 | AFLAC | $36 | $0 | $36 | 0.40% |
| 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. | $784 | $0 | $784 | 10.20% |
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 | 145 | $775K |
| Dental | DELTA DENTAL OF MICHIGAN | 137 | $44K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 124 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $25K |
| Short-term disability | AFLAC | 12 | $9K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $25K |
| Prescription drug | PRIORITY HEALTH | 145 | $775K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.