| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOEKWATER, LINNEA3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $17K | $0 | $17K | 2.62% |
| LUDEMA SCOTT3 Filed as: LUDEMA, SCOTT | 1 SOUTH WAVERLY ROAD HOLLAND, MI 49423 | PRIORITY HEALTH | $9K | $0 | $9K | 1.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 11.65% |
| OTTAWA KENT INSURANCE AGENCY3 Filed as: OTTAWA KENT INSURANCE AGENCY, INC. | 1 SOUTH WAVERLY ROAD HOLLAND, MI 49423 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 2.61% |
| OTTAWA KENT INSURANCE3 | 7472 MAIN STREET, PO BOX 349 JENISON, MI 49429 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 2.08% |
| MICHIGAN CHAMBER SERVICES, INC.3 | 600 SOUTH WALNUT STREET LANSING, MI 48933 | DELTA DENTAL OF MICHIGAN | $1K | $0 | $1K | 2.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | DELTA DENTAL OF MICHIGAN | $534 | $0 | $534 | 1.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 203 NORTH LA SALLE STREET, FLOOR 20 CHICAGO, IL 60601 | DELTA DENTAL OF MICHIGAN | $256 | $0 | $256 | 0.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | VISION SERVICE PLAN INSURANCE | $777 | $0 | $777 | 7.38% |
| OTTAWA KENT INSURANCE AGENCY3 Filed as: OTTAWA KENT INSURANCE AGENCY, INC. | PO BOX 349 JENISON, MI 49429 | VISION SERVICE PLAN INSURANCE | $274 | $0 | $274 | 2.60% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 112 | $654K |
| Dental | DELTA DENTAL OF MICHIGAN | 135 | $50K |
| Vision | VISION SERVICE PLAN INSURANCE | 81 | $11K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $57K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $57K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.