| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BUILDING 3, SUITE 500 AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $19K | $149K | $168K | 14.98% |
| TODD HARTSHORN3 | 6074 JACKSONTOWN ROAD HEALTH, OH 43056 | AETNA LIFE INSURANCE COMPANY | $24K | — | $24K | 2.12% |
| BENEFIT MALL3 | 4851 LBJ FREEWAY, SUITE 100 DALLAS, TX 75244 | AETNA LIFE INSURANCE COMPANY | $15K | — | $15K | 1.38% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 0.30% |
| WILLMS, HARTSHORN AND ASSOCIATES3 | 2000 NEWARK GRANVILLE ROAD SUITE 200 GRANVILLE, OH 43023 | HUMANA HEALTH PLAN, INC. | $5K | — | $5K | 2.73% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | PO BOX 1687 TOLEDO, OH 43603 | HUMANA HEALTH PLAN, INC. | $2K | — | $2K | 1.32% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BUILDING 3, SUITE 500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $15K | $12K | $27K | 29.78% |
| TODD HARTSHORN3 | 6074 JACKSONTOWN ROAD HEALTH, OH 43056 | TRANSAMERICA LIFE INSURANCE COMPANY | $199 | — | $199 | 0.22% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BUILDING 3, SUITE 500 AUSTIN, TX 78730 | ACE COMPANIES | $7K | $6K | $13K | 25.56% |
| TODD HARTSHORN3 | 6074 JACKSONTOWN ROAD HEALTH, OH 43056 | ACE COMPANIES | $2K | — | $2K | 4.09% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | ACE COMPANIES | $175 | — | $175 | 0.35% |
| WILLMS, HARTSHORN AND ASSOCIATES3 | 2000 NEWARK GRANVILLE ROAD SUITE 200 GRANVILLE, OH 43023 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 7.99% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. AND FIN. SERVICES | 4851 LBJ FREEWAY, SUITE 1100 DALLAS, TX 75244 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $947 | $3K | 5.92% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 565 METRO PLACE SOUTH, SUITE 450 DUBLIN, OH 43017 | METROPOLITAN LIFE INSURANCE COMPANY | $817 | $216 | $1K | 2.20% |
| WILLMS, HARTSHORN AND ASSOCIATES3 | 2000 NEWARK GRANVILLE ROAD GRANVILLE, OH 43023 | HUMANA INSURANCE COMPANY OF KENTUCKY | $75 | — | $75 | 7.09% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | PO BOX 1687 TOLEDO, OH 43603 | HUMANA INSURANCE COMPANY OF KENTUCKY | $29 | — | $29 | 2.74% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 354 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 172 | $47K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 172 | $47K |
| Life insurance(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 1,102 | $140K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 172 | $47K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 354 | $1.3M |
| Other(4 contracts, 4 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 1,102 | $191K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,102 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.