| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEVIN J MCPHERSON3 | 244 NORTH ROSE STREET KALAMAZOO, MI 490073887 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $13K | — | $13K | 2.06% |
| SUSAN L CULHANE3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.54% |
| JAMES C. TEACHOUT3 | 1204 E CENTRE AVE PORTAGE, MI 490025510 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $2K | $436 | $3K | 0.43% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW STE 101 GRAND RAPIDS, MI 495449544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $534 | — | $534 | 0.09% |
| KEVIN J MCPHERSON3 | 244 NORTH ROSE STREET KALAMAZOO, MI 490073887 | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 2.18% |
| JAMES C. TEACHOUT3 | 1204 E CENTRE AVE PORTAGE, MI 490025510 | BLUE CARE NETWORK OF MICHIGAN | $552 | $104 | $656 | 0.35% |
| SUSAN L CULHANE3 | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | BLUE CARE NETWORK OF MICHIGAN | $538 | — | $538 | 0.29% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW STE 101 GRAND RAPIDS, MI 495449544 | BLUE CARE NETWORK OF MICHIGAN | $141 | — | $141 | 0.08% |
| ROSE STREET ADVISORS LLC | 244 N ROSE ST KALAMAZOO, MI 49007 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 12.00% |
| THE NULTY AGENCY INC. Filed as: THE NULTY AGENCY INC | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | DEARBORN LIFE INSURANCE COMPANY | $12 | — | $12 | 0.07% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 132 | $810K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 132 | $624K |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 132 | $624K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 94 | $18K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 132 | $810K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.