| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF IN LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | -$36 | $2K | 13.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2167 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $492 | — | $492 | 3.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2167 GRAND RAPIDS, MI 49501 | AFLAC | $432 | $0 | $432 | 9.82% |
| ASHLEY M. MESSENGER3 Filed as: ASHLEY MARIE MESSENGER | 41 26TH STREET NORTH BATTLE CREEK, MI 49015 | AFLAC | $171 | $19 | $190 | 4.32% |
| ALYSSA DAISY WRAY3 | 2618 LUCERNE DRIVE JACKSON, MI 49201 | AFLAC | $102 | $0 | $102 | 2.32% |
| MARY A THOMAS3 Filed as: MARY A. THOMAS | 18101 WEST AUSTIN ROAD MANCHESTER, MI 48158 | AFLAC | $37 | $0 | $37 | 0.84% |
| MJ INSURANCE3 Filed as: BETHANY MCDADE & VARIOUS AGENTS | 9674 R AVENUE MATTAWAN, MI 49071 | AFLAC | $32 | $0 | $32 | 0.73% |
| CONNIE RUPERT3 Filed as: CONNIE M. RUPERT | 518 NORTH EVANS STREET TECUMSEH, MI 49286 | AFLAC | $22 | $7 | $29 | 0.66% |
| DEAN F SHIPMAN3 Filed as: DEAN FRANCIS SHIPMAN | 13600 OWEN ROAD BROOKLYN, MI 49230 | AFLAC | $11 | $2 | $13 | 0.30% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 7 | $4K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $14K |
| Short-term disability | AFLAC | 7 | $4K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $14K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.