| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARY JO LEFEVRE3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | PRIORITY HEALTH | $6K | $0 | $6K | 4.00% |
| MARY JO LEFEVRE3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | PRIORITY HEALTH INSURANCE COMPANY | $4K | $0 | $4K | 4.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH, LLC | UNKNOWN ORION, MI 48359 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $652 | $652 | 5.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | DELTA DENTAL OF MICHIGAN | $508 | $0 | $508 | 4.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | DELTA DENTAL OF MICHIGAN | $252 | $0 | $252 | 1.99% |
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) | PRIORITY HEALTH | 109 | $234K |
| Dental | DELTA DENTAL OF MICHIGAN | 167 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $13K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $13K |
| Prescription drug(2 contracts, 2 carriers) | PRIORITY HEALTH | 109 | $234K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.