| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN GRAND RAPIDS, MI 49512 | BLUE CARE NETWORK OF MICHIGAN | $28K | $0 | $28K | 2.74% |
| UNKNOWN3 | UNKNOWN GRAND RAPIDS, MI 49512 | BLUE CARE NETWORK OF MICHIGAN | $6K | $0 | $6K | 0.60% |
| DENISE R VANPUTTEN3 | UNKNOWN GRAND RAPIDS, MI 49512 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | $0 | $3K | 2.08% |
| JAMIE REAL3 | 2755 ARBORVIEW DRIVE APARTMENT 201 TRAVERSE CITY, MI 49685 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $417 | $0 | $417 | 0.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS. AGENCY | PO BOX 953 GRANDVILLE, MI 49468 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $223 | $223 | 0.19% |
| KIMBERLY A. TRENT3 Filed as: KIMBERLY A TRENT | 625 KENMOOR AVENUE SE SUITE 200 GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $63 | $0 | $63 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF MICHIGAN | $5K | $0 | $5K | 5.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 15.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 625 KENMOOR AVENUE SE GRAND RAPIDS, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 4.38% |
| MJ INSURANCE3 Filed as: JEFFREY C WERNER AND VARIOUS AGENTS | 18096 TRUDY DRIVE SPRING LAKE, MI 49456 | CONTINENTAL AMERICAN INSURANCE COMPANY | $545 | $0 | $545 | 2.16% |
| STEVEN R. MILLER3 Filed as: STEVEN R MILLER | 89 MONROE CENTER NW SUITE 200 GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $541 | $0 | $541 | 2.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE | 3055 44TH STREET SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $424 | $0 | $424 | 1.68% |
| BOR HOUSE ACCOUNT3 | UNKNOWN GRAND RAPIDS, MI 49512 | CONTINENTAL AMERICAN INSURANCE COMPANY | $423 | $0 | $423 | 1.68% |
| SARAH E MEANY3 Filed as: SARAH E PORTER | 2710 HAMPSHIRE BOULEVARD SE GRAND RAPIDS, MI 49506 | CONTINENTAL AMERICAN INSURANCE COMPANY | $342 | $0 | $342 | 1.36% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $323 | $0 | $323 | 1.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 625 KENMOOR SE GRAND RAPIDS, MI 49546 | EYEMED VISION CARE | $1K | $0 | $1K | 9.70% |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 213 | $1.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 254 | $92K |
| Vision | EYEMED VISION CARE | 195 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $82K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $82K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 213 | $1.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.