| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 16253 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | PRIORITY HEALTH | $78K | $0 | $78K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $0 | $18K | 7.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5435 CORPORATE DRIVE, SUITE 260 TROY, MI 48098 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $12K | $12K | 4.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 3.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 0.81% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LA SALLE STREET, FLOOR 20 CHICAGO, IL 60601 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 0.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD, FLOOR 14 CHICAGO, IL 60604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 35.57% |
| KIMBERLEE DIEL3 | 5841 DOVER LANE TRAVERSE CITY, MI 49685 | CONTINENTAL AMERICAN INSURANCE COMPANY | $848 | $0 | $848 | 18.41% |
| SHANNON DEON MERRITT3 Filed as: SHANNON KENDALL BOUGHNER | 12363 AFTON ROAD WOLVERINE, MI 49799 | CONTINENTAL AMERICAN INSURANCE COMPANY | $222 | $0 | $222 | 4.82% |
| MARTINA AREND3 Filed as: MARTINA ANTJE AREND | 1756 HAMMER ROAD KINGSLEY, MI 49649 | CONTINENTAL AMERICAN INSURANCE COMPANY | $122 | $0 | $122 | 2.65% |
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 | 198 | 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) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 447 | $2.6M |
| Dental | DELTA DENTAL OF MICHIGAN | 482 | $166K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 484 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $243K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $243K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $243K |
| Prescription drug | PRIORITY HEALTH | 447 | $2.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $248K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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.