| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | SUN LIFE | — | $16K | $16K | 2.24% |
| UMR, INC.3 Filed as: UMR, INC | 11 SCOTT ST, STE 100 WAUSAU, WI 54403 | SUN LIFE | — | $5K | $5K | 0.72% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.25% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | SUN LIFE | — | $10K | $10K | 2.06% |
| UMR, INC.3 Filed as: UMR, INC | 11 SCOTT ST, STE 100 WAUSAU, WI 54403 | SUN LIFE | — | $3K | $3K | 0.65% |
| HYLANT GROUP INC3 | PO BOX 1687 TOLEDO, OH 436031687 | HARTFORD LIFE AND ACCIDENT | $13K | $4K | $17K | 4.70% |
| BENEFIT PLAN ADMINISTRATORS | 402 GRAHAM AVE BOX 1128 EAU CLAIRE, WI 54702 | UNITED STATE FIRE INSURANCE COMPANY | — | $50K | $50K | 15.33% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | SUN LIFE | — | $6K | $6K | 2.19% |
| UMR, INC.3 Filed as: UMR, INC | 11 SCOTT ST, STE 100 WAUSAU, WI 54403 | SUN LIFE | — | $2K | $2K | 0.69% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $703 | $703 | 0.73% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.08% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 1.24% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $11K | $11K | 21.31% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.46% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.36% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.36% |
| AMWINS5 | 50 WHITECAP DR NORTH KINGSTOWN, RI 02852 | STONEBRIDGE LIFE INSUARANCE MEDICATE GENERATION RX (EMPLOYER PDP) | $4K | — | $4K | 10.00% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | STONEBRIDGE LIFE INSUARANCE MEDICATE GENERATION RX (EMPLOYER PDP) | $491 | — | $491 | 1.11% |
| AMWINS5 | 50 WHTECAP DR NORTH KINGSTOWN, RI 02852 | MONUMENTAL LIFE INSURANCE CO. MEDICARE SUPPLEMENT | $6K | — | $6K | 14.12% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | MONUMENTAL LIFE INSURANCE CO. MEDICARE SUPPLEMENT | $2K | — | $2K | 3.53% |
| HYLANT GROUP INC Filed as: HYANT GROUP - FT WAYNE | 811 MADISON AVE TOLEDO, OH 43604 | EYEMED | $4K | — | $4K | 9.97% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.92% |
| HYLANT GROUP INC3 | 811 MADISION AVE TOLEDO, OH 43604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $717 | $717 | 4.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $901K |
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 | 1,908 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MONUMENTAL LIFE INSURANCE CO. MEDICARE SUPPLEMENT | 21 | $43K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,014 | $607K |
| Vision(3 contracts) | EYEMED | 1,246 | $144K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,697 | $504K |
| Short-term disability(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 816 | $441K |
| Long-term disability(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 816 | $422K |
| Prescription drug | STONEBRIDGE LIFE INSUARANCE MEDICATE GENERATION RX (EMPLOYER PDP) | 21 | $44K |
| Stop-loss / reinsurancereinsurance(4 contracts, 2 carriers) | SUN LIFE | 630 | $1.8M |
| Other(6 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,697 | $737K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,697 | — |
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.