| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAARY JO LEFEVRE | 2401 W BIG BEAVER SUITE 400 TROY, MI 48084 | PRIORITY HEALTH | $22K | — | $22K | 4.00% |
| MARY JO LEFEVRE | 2401 W BIG BEAVER SUITE 400 TROY, MI 48084 | PRIORITY HEALTH | $12K | — | $12K | 4.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 8 CADILLAC DRIVE BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 5.83% |
| HYLANT GROUP INC7 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| HYLANT GROUP INC7 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| HYLANT GROUP INC7 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 8 CADILLAC DRIVE BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $512 | — | $512 | 5.87% |
| HYLANT GROUP INC7 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $333 | — | $333 | 14.98% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | PRIORITY HEALTH | 141 | $861K |
| Dental(2 contracts) | DELTA DENTAL OF MICHIGAN | 157 | $60K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $22K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $28K |
| Long-term disability | INSURANCE COMPANY OF NORTH AMERICA | 65 | $14K |
| Prescription drug(2 contracts) | PRIORITY HEALTH | 141 | $861K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.