| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | AMERITAS LIFE INSURANCE CORP. | $6K | $363 | $6K | 8.06% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INS AGENCY INC | 650 TRADE CENTRE WAY STE 310 PORTAGE, MI 490020402 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 2.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH ST. SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 13.00% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $484 | — | $484 | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH ST. SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 18.82% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $873 | — | $873 | 3.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH ST. SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.17% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $480 | — | $480 | 2.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH ST. SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $948 | $793 | $2K | 13.99% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $296 | — | $296 | 2.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGY INC | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $636 | $752 | $1K | 16.79% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC | PO BOX 11177 SOUTH BEND, IN 46634 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $191 | — | $191 | 2.31% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 200 | $79K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 200 | $79K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $12K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.