| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT | PO BOX 953 GRANDVILLE, MI 49468 | HUMANA INSURANCE COMPANY | $9K | $6K | $15K | 15.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 25.67% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $607 | $607 | 1.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 25.76% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $612 | $612 | 1.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $3K | $13K | 26.01% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $616 | $616 | 1.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INSURANCE A | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.01% |
| FMLASOURCE INC3 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 154.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICK STUIT INS AGENCY | 3055 44TH STREET SOUTHWEST GRANDVILLE, MI 49418 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $559 | $171 | $730 | 26.10% |
| NFP INSURANCE SERVICES INC3 | 1250 SOUTH CAPITAL OF TEXAS HIGHWAY SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $36 | $36 | 1.29% |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 319 | $1.7M |
| Dental | HUMANA INSURANCE COMPANY | 164 | $100K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 141 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 187 | $54K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $51K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 187 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.