| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN G. DOWNS3 | 2401 W BIG BEAVER RD, SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | $24K | $31K | 1.72% |
| AGIS - MICHIGAN AGENCY LLC3 Filed as: AGIS MICHIGAN AGENCY, LLC | 30701 WOODWARD, STE 400 ROYAL OAK, MI 48073 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $5K | $5K | 0.25% |
| HYLANT GROUP INC3 | 2401 W BIG BEAVER RD, SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $363 | $363 | 0.02% |
| HYLANT GROUP INC3 | 8 CADILLAC DR SUITE 230 BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 4.69% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $4K | $8K | 6.06% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $644 | $644 | 0.50% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $556 | $2K | 12.65% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $93 | $93 | 0.47% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $450 | $3K | 17.96% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $75 | $75 | 0.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Insurance services; Claims processing; Direct payment from the plan Service code 12 | — | $154K |
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 | 414 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 192 | $1.8M |
| Dental | DELTA DENTAL OF MICHIGAN | 414 | $132K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 220 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 220 | $129K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 220 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.