| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISON AVENUE, 8TH FL TOLEDO, OH 43604 | AETNA LIFE INSURANCE COMPANY | $20K | — | $20K | 2.93% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGENCY & FINANCIAL | 12404 PARK CENTRAL DRIVE DALLAS, TX 75251 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 1.40% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 5.86% |
| ASSUREDPARTNERS3 Filed as: PREFERRED BENFITS SERVICE AGENCY | 611 SOUTH SANDUSKY STREET PO BOX 868 DELAWARE, OH 43015 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 1.36% |
| EDWARD D SOMMER3 Filed as: EDWARD D.A. SOMMER | 300 W WILSON BRIDGE ROAD, SUITE 300 WORTHINGTON, OH 43085 | VISION SERVICE PLAN | $919 | — | $919 | 8.00% |
| PREFERRED BENEFITS SERVICES AGENCY3 | PO BOX 868 DELAWARE, OH 43015 | VISION SERVICE PLAN | $204 | — | $204 | 1.78% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43603 | VISION SERVICE PLAN | $189 | — | $189 | 1.65% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $22 | $2K | 18.79% |
| PREFERRED BENEFITS SERVICES AGENCY3 Filed as: PREFERRED BNFT SVCS AGCY INC | PO BOX 868 DELAWARE, OH 43015 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $120 | — | $120 | 1.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUSTOM DESIGN BENEFITS EIN 81-0798821 ADMINISTRATOR | Claims processing Service code 12 | — | $6K |
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 | 139 | 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) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 134 | $797K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 211 | $97K |
| Vision | VISION SERVICE PLAN | 71 | $11K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 211 | $97K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 211 | $97K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 19 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.