| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUSAN L CULHANE3 Filed as: SUSAN L. CULHANE | 5579 STADIUM DRIVE KALAMAZOO, MI 490091929 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $52K | — | $52K | 0.81% |
| ACRISURE LLC3 Filed as: ACRUSURE, LLC | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $7K | $7K | 0.11% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, INC. | 5579 STADIUM DRIVE KALAMAZZO, MI 49009 | AMERITAS LIFE INSURANCE CORPORTATION | $5K | $2K | $7K | 1.70% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY | 5579 STADIUM DRIVE KALAMAZOO, MI 49009 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $17K | — | $17K | 7.10% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | -$206 | -$206 | -0.08% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY | 5579 STADIUM DRIVE KALAMAZZO, MI 49009 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $6K | — | $6K | 5.46% |
| THE NULTY AGENCY INC.3 Filed as: THE NULTY AGENCY, INC. | 5579 STADIUM DRIVE KALAMAZZO, MI 49009 | EYEMED | $6K | — | $6K | 9.95% |
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 | 668 | 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) | 668 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,211 | $6.5M |
| Dental | AMERITAS LIFE INSURANCE CORPORTATION | 566 | $441K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORPORTATION | 924 | $497K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 668 | $243K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 668 | $117K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,211 | $6.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,211 | — |
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.