| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W SCHUEMANN3 Filed as: JOHN SHUEMANN | 244 NORTH ROSE STREET KALAMAZOO, MI 49007 | PRIORITY HEALTH | $45K | $0 | $45K | 2.95% |
| DOUGLAS W. NAGEL, JR.3 Filed as: DOUGLAS W NAGEL, JR. | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | PRIORITY HEALTH | $11K | $0 | $11K | 0.74% |
| JAMES PRIEST3 Filed as: JAMES R DICKSON | ONE BURTON HILLS BOULEVARD SUITE 200 NASHVILLE, TN 37215 | PRIORITY HEALTH | $6K | $0 | $6K | 0.42% |
| ROBERT S. VANDERVEEN3 Filed as: ROBERT S VANDERVEEN | 625 KENMOOR AVENUE SOUTHEAST SUITE 200 GRAND RAPIDS, MI 49546 | PRIORITY HEALTH | $264 | $0 | $264 | 0.02% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | PRIORITY HEALTH | -$4K | $0 | -$4K | -0.25% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, INC | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 6.01% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, SUITE 8 BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.01% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 NORTH ROSE STREET KALAMAZOO, MI 49007 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.18% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, INC | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $415 | $0 | $415 | 7.47% |
| ROSE STREET ADVISORS LLC3 Filed as: ROSE STREET ADVISORS, LLC | 244 NORTH ROSE STREET KALAMAZOO, MI 49007 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $142 | $0 | $142 | 2.55% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PRIORITY HEALTH | 297 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 159 | $77K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $83K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 159 | $77K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.