| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 24 FRANK LLOYD WRIGHT DR STE J4100 ANN ARBOR, MI 48105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $14K | $14K | 1.14% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. GADY EVAN THOMAS | 811 MADISON AVE TOLEDO, OH 43604 | HEALTH RESOURCES, INC. | $56K | — | $56K | 5.00% |
| HYLANT GROUP INC3 | 301 PENNSYLVANIA PKWY STE 201 INDIANAPOLIS, IN 46280 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $6K | $22K | 7.12% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 100 S COLLEGE AVE STE 230 BLOOMINGTON, IN 474045163 | VISION SERVICE PLAN | $5K | — | $5K | 1.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WEBTPA EMPLOYER SERVICES, INC. EIN 75-2611444 NONE | Claims processing; Contract Administrator Service code 12 | — | $577K |
| MAGELLAN RX MANAGEMENT INC EIN 46-3708039 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $130K |
| PATOKA VALLEY EIN 35-1922246 NONE | Other fees; Claims processing Service code 12 | — | $84K |
| CONNECTICUT GENERAL LIFE EIN 06-0303370 NONE | Claims processing Service code 12 | — | $14K |
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 | 1,264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTH RESOURCES, INC. | 3,140 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,158 | $265K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,252 | $306K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,252 | $306K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,138 | $1.2M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,252 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,140 | — |
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.