| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE NULTY AGENCY INC.3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | PRIORITY HEALTH | $74K | $0 | $74K | 2.37% |
| THE NULTY AGENCY INC.3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | DELTA DENTAL OF MICHIGAN | $9K | $0 | $9K | 2.77% |
| THE NULTY AGENCY INC.3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | UNUM LIFE INSURANCE CO OF AMER | $15K | $643 | $16K | 14.50% |
| CENTRO BENEFITS RESEARCH LLC0 | 325 N KIRKWOOD RD, STE 300 KIRKWOOD, MO 63122 | UNUM LIFE INSURANCE CO OF AMER | $0 | $4K | $4K | 3.96% |
| THE NULTY AGENCY INC.3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | UNUM LIFE INSURANCE CO OF AMER | $6K | $451 | $6K | 8.38% |
| CENTRO BENEFITS RESEARCH LLC0 | 325 N KIRKWOOD RD, STE 300 KIRKWOOD, MO 63122 | UNUM LIFE INSURANCE CO OF AMER | $0 | $3K | $3K | 3.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, A MARSH & MCLENNAN AGENC | 20 N MARTINGALE ROAD, SUITE 100 SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE (EYEMED VISION CARE) | $5K | $0 | $5K | 10.23% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, A MARSH & MCLENNAN AGENC | 20 N MARTINGALE ROAD, SUITE 100 SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE (EYEMED VISION CARE) | $14 | $0 | $14 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO OF AMER EIN 01-0278678 ADMIN OF ST DISAB | Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Contract Administrator Service code 12 | — | $24K |
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 | 412 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 739 | $3.1M |
| Dental | DELTA DENTAL OF MICHIGAN | 807 | $330K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE (EYEMED VISION CARE) | 674 | $56K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE CO OF AMER | 412 | $185K |
| Long-term disability | UNUM LIFE INSURANCE CO OF AMER | 412 | $76K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE CO OF AMER | 412 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 807 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.