| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | PRIORITY HEALTH | $41K | — | $41K | 3.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | PRIORITY HEALTH INSURANCE COMPANY | $4K | — | $4K | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | DELTA DENTAL OF MICHIGAN | $4K | $245 | $5K | 6.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 15.04% |
| JON A RYBICKI3 | 71 129TH AVE WAYLAND, MI 49348 | AFLAC | $5K | $341 | $5K | 9.89% |
| WILLIAM JOHNSON & ASSOC LLC3 | 1755 INDIAN LAKES RD CEDAR SPRINGS, MI 49319 | AFLAC | $1K | $68 | $2K | 2.86% |
| EOWALTER3 LLC3 | 42906 SENATE PL NOVI, MI 48375 | AFLAC | $544 | $68 | $612 | 1.14% |
| NICOLE DOLPHIN3 | 3112 PLAZA DR NE APT C20 GRAND RAPIDS, MI 49525 | AFLAC | $363 | — | $363 | 0.68% |
| MERRI C SMITH3 | 492 142ND AVE CALEDONIA, MI 49316 | AFLAC | $125 | — | $125 | 0.23% |
| EDWARD O WALTER III3 Filed as: EDWARD 0 WALTER III | PO BOX 1377 GRAND RAPIDS, MI 49501 | AFLAC | $54 | — | $54 | 0.10% |
| MARY E WILLS3 | 9257 CLEVELAND ST APT 102 MERRILLVILLE, IN 46410 | AFLAC | $44 | — | $44 | 0.08% |
| DANIEL JAY BOONE3 | 3340 PROSPECT ST HUDSONVILLE, MI 49426 | AFLAC | $44 | — | $44 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | AFLAC | $32 | — | $32 | 0.06% |
| TJY BENEFITS CORPORATION3 | 6737 BLUE HUMMINGBIRD WAY NE BELDING, MI 48809 | AFLAC | $32 | — | $32 | 0.06% |
| JEFFREY C WERNER3 Filed as: JEFFREY WERNER LLC | 18096 TRUDY DR SPRING LAKE, MI 49456 | AFLAC | $26 | — | $26 | 0.05% |
| THOMAS S WICKEY3 | 3497 LONG GROVE DR SE KENTWOOD, MI 49512 | AFLAC | $23 | — | $23 | 0.04% |
| CHARLES V GLAUB3 | 4404 SAINT ANDREWS ST HOWELL, MI 48843 | AFLAC | $19 | — | $19 | 0.04% |
| ANNA LORELEI WIERENGA3 | 12860 VALLEY DR WAYLAND, MI 49348 | AFLAC | $14 | — | $14 | 0.03% |
| MATTHEW P JOHNSON3 | 1002 W GRAND RIVER AVE WILLIAMSTON, MI 48895 | AFLAC | $13 | — | $13 | 0.02% |
| BETH LUANNE KIMBROUGH3 | 6750 N ANDREWS AVE STE 200 FT LAUDERDALE, FL 33309 | AFLAC | $12 | — | $12 | 0.02% |
| MARY EVELYN LEGGETT3 | 522 MAPLE ST ALLEGAN, MI 49010 | AFLAC | $11 | — | $11 | 0.02% |
| WESLEY A SMITH3 | 8522 CURLEY TRL SE CALEDONIA, MI 49316 | AFLAC | $11 | — | $11 | 0.02% |
| AG AND ASSOCIATES3 Filed as: AG & ASSOCIATES | PO BOX 339 BELLAIRE, MI 49615 | AFLAC | $9 | — | $9 | 0.02% |
| STEPHANIE L KESSELRING3 | 5434 OAKHURST DR SEMINOLE, FL 33772 | AFLAC | $9 | — | $9 | 0.02% |
| SANTIAGO & ASSOCIATES LLC3 | 5480 PINE BLUFF LN MUSKEGON, MI 49441 | AFLAC | $9 | — | $9 | 0.02% |
| ELWYN D JOSLIN3 | PO BOX 197 CEDAR SPRINGS, MI 49319 | AFLAC | $8 | — | $8 | 0.01% |
| ACTION FINANCIAL PLANNING INC3 | 191 NORTH AVE STE A MOUNT CLEMENS, MI 48043 | AFLAC | $8 | — | $8 | 0.01% |
| RANDALL L KIMBLER3 | PO BOX 302 HESPERIA, MI 49421 | AFLAC | $7 | — | $7 | 0.01% |
| JEREMY D SAMPSEL3 | 3030 S 9TH ST STE 2K KALAMAZOO, MI 49009 | AFLAC | $7 | — | $7 | 0.01% |
| SPAZ AND GLAUB ENTERPRISES3 | PO BOX 339 BELLAIRE, MI 49615 | AFLAC | $6 | — | $6 | 0.01% |
| DENNIS FENNELL3 Filed as: DENNIS R BELGER | PO BOX 215 NORTH STREET, MI 48049 | AFLAC | $6 | — | $6 | 0.01% |
| HEATHER A DOLLIVER3 | 2150 ASSOCIATION DR OKEMOS, MI 48864 | AFLAC | $6 | — | $6 | 0.01% |
| DOUGLAS E FOX3 | 6836 THAYER LAKE DR ALDEN, MI 49612 | AFLAC | $6 | — | $6 | 0.01% |
| JON MARTIN KETCHAM3 | 1947 142ND AVE DORR, MI 49323 | AFLAC | $5 | — | $5 | 0.01% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $4 | — | $4 | 0.01% |
| THOMAS W BOSTON3 Filed as: THOMAS A DANKO | 71550 ELDRED RD BRUCE TWP, MI 48065 | AFLAC | $3 | — | $3 | 0.01% |
| JAMES C SNIDER JR3 | 457 MANOR RD MAITLAND, FL 32751 | AFLAC | $2 | — | $2 | 0.00% |
| HEIDI E GLAUB3 | 4404 SAINT ANDREWS ST HOWELL, MI 48843 | AFLAC | $2 | — | $2 | 0.00% |
| THOMAS W BOSTON3 Filed as: THOMAS W RINGWALD | 37231 N 110TH ST SCOTTSDALE, AZ 85262 | AFLAC | $2 | — | $2 | 0.00% |
| JAMES BULLOCK3 | 3715 POWDERHORN DR OKEMOS, MI 48864 | AFLAC | $2 | — | $2 | 0.00% |
| ANDREW K GLAUB3 | PO BOX 339 BELLAIRE, MI 49615 | AFLAC | $1 | — | $1 | 0.00% |
| MICHELLE R CALVIN3 | PO BOX 99 JONESVILLE, MI 49250 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTOPHER D BOULDREY3 | PO BOX 602 CONCORD, MI 49237 | AFLAC | $1 | — | $1 | 0.00% |
| JULIE SLAUGHTER3 | 31211 GRANDON ST LIVONIA, MI 48150 | AFLAC | $1 | — | $1 | 0.00% |
| CAROL J THOMPSON3 | 51717 SUMMER WOOD CT GRANGER, IN 46530 | AFLAC | $1 | — | $1 | 0.00% |
| MATTHEW M NACHAZEL3 | 16473 BAYWOOD LN GRANGER, IN 46530 | AFLAC | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BERENDS HENDRICKS STUIT INS AGENCY | 3055 44TH ST SW GRANDVILLE, MI 49418 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.58% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PRIORITY HEALTH | 283 | $1.4M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MICHIGAN | 277 | $126K |
| Vision(2 contracts, 2 carriers) | AFLAC | 239 | $67K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $59K |
| Short-term disability | AFLAC | 48 | $54K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 283 | $1.4M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
No prospect flags tripped on this filing.