| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIENA M ATKINSON3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $48K | — | $48K | 1.75% |
| CASSIE GOODBAND3 | 444 W MICHIGAN AVENUE KALAMAZOO, MI 49007 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $27K | — | $27K | 0.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $3K | $3K | 0.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD STE 14B CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $28K | $32K | 12.27% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $815 | — | $815 | 0.31% |
| TRIENA M ATKINSON3 | 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49503 | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 1.64% |
| CASSIE GOODBAND3 | 444 W MICHIGAN AVENUE KALAMAZOO, MI 49007 | BLUE CARE NETWORK OF MICHIGAN | $3K | — | $3K | 1.31% |
| MICHIGAN CHAMBER SERVICES, INC.3 | JASON RUSSELL 600 S WALNUT ST LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $4K | — | $4K | 2.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | TRIENA ATKINSON 1591 GALBRAITH AVE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 1.85% |
| ACRISURE LLC3 | CASSIE GOODBAND 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 1.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD STE 14B CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $3K | $8K | 14.87% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD STE 14B CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.18% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $930 | — | $930 | 2.57% |
| MICHIGAN CHAMBER SERVICES, INC.3 Filed as: MICHIGAN CHAMBER SERVICES INC | 600 S WALNUT ST LANSING, MI 48933 | VISION SERVICE PLAN | $5K | — | $5K | 17.09% |
| ACRISURE LLC3 | DBA KEYSER INS GROUP 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | VISION SERVICE PLAN | $1K | — | $1K | 4.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN | $491 | — | $491 | 1.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BLVD STE 14B CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $2K | $3K | 12.51% |
| ACRISURE LLC3 | 444 W MICHIGAN AVE KALAMAZOO, MI 49007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $684 | — | $684 | 2.56% |
| JACQUILINE TUCKEY HARKEMA REVOCABLE4 | TRUST 305 AGOLI LN LOUDON, TN 37774 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $613 | — | $613 | 7.10% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD CHICAGO, IL 60604 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $427 | — | $427 | 4.95% |
| ACRISURE LLC4 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $39 | — | $39 | 0.45% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 417 | $3.0M |
| Dental | DELTA DENTAL OF MICHIGAN | 468 | $184K |
| Vision | VISION SERVICE PLAN | 198 | $28K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $78K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $263K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $36K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 417 | $3.0M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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.