| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT LUDEMA3 | 1 S WAVERLY ROAD HOLLAND, MI 49423 | PRIORITY HEALTH | $13K | — | $13K | 2.15% |
| LINNEA HOEKWATER3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $11K | — | $11K | 1.85% |
| OTTAWA KENT INSURANCE AGENCY3 | 7472 MAIN STREET JENISON, MI 49428 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 9.68% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 9.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3011 ARMORY DRIVE SUITE 250 NASHVILLE, TN 37204 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $806 | $0 | $806 | 1.26% |
| OTTAWA KENT INSURANCE3 | 7472 MAIN STREET JENISON, MI 49429 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 3.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 2.79% |
| MICHIGAN CHAMBER SERVICES, INC.3 | 600 SOUTH WALNUT STREET LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $946 | $0 | $946 | 2.02% |
| OTTAWA KENT INSURANCE AGENCY3 Filed as: OTTAWA KENT INSURANCE AGENCY, INC. | PO BOX 349 JENISON, MI 49429 | VISION SERVICE PLAN INSURANCE | $637 | — | $637 | 6.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN INSURANCE | $342 | — | $342 | 3.49% |
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 | 96 | 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) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 91 | $586K |
| Dental | DELTA DENTAL OF MICHIGAN | 122 | $47K |
| Vision | VISION SERVICE PLAN INSURANCE | 68 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $64K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $64K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.