| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANJA HARMON3 | 1591 GALBRAITH AVENUE SE GRAND RAPIDS, MI 49546 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $20K | $0 | $20K | 1.75% |
| JASON A. FREEMAN3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | $0 | $15K | 1.36% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $2K | $2K | 0.19% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $781 | $3K | 6.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 5435 CORPORATE DRIVE, SUITE 260 TROY, MI 48098 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.37% |
| PROLIANT INC5 | 1100 ABERNATHY ROAD, SUITE 1000 ATLANTA, GA 30328 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $272 | $272 | 0.60% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 170 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 170 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 170 | $1.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $45K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $45K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 170 | $1.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.