| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CARE NETWORK OF MICHIGAN | — | BLUE CARE NETWORK OF MICHIGAN | $39K | — | $39K | 2.34% |
| ROBERT A KELLEHER3 Filed as: ROBERT A. KELLEHER | PO BOX 1687 TOLEDO, OH 43603 | BLUE CROSS BLUE SHIELD | $30K | — | $30K | 2.34% |
| RYAN C VALEK3 | 811 MADISON AVE TOLEDO, OH 43604 | BLUE CROSS BLUE SHIELD | $27K | — | $27K | 2.12% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC (ANN ARBOR) | PO BOX 541 ANN ARBOR, MI 48106 | BLUE CROSS BLUE SHIELD | — | $5K | $5K | 0.43% |
| PATRICK MOORE3 | 222 S RIVERSIDE 630 CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD | $5K | — | $5K | 0.39% |
| HYLANT GROUP INC2 | 811 MADISON AVE 8TH FL TOLEDO, OH 43604 | THE HARTFORD | $6K | — | $6K | 14.93% |
| HYLANT GROUP INC2 | ATTN ACCOUNTING PO BOX 1687 TOLEDO, OH 43603 | THE HARTFORD | $28 | — | $28 | 0.07% |
| HYLANT GROUP INC3 | 1440 ARROWHEAD DRIVE MAUMEE, OH 43537 | GUARDIAN | $6K | $1K | $7K | 22.89% |
| HYLANT GROUP INC | 811 MADISON AVE 8TH FL TOLEDO, OH 43604 | AMERICAN UNITED LIFE INSURANCE COMPANY | $4K | $1K | $6K | 20.02% |
| HYLANT GROUP INC | 811 MADISON AVE 8TH FL TOLEDO, OH 43604 | AMERICAN UNITED LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.61% |
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 | 426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 55 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 682 | $2.9M |
| Dental | GUARDIAN | 479 | $30K |
| Life insurance(2 contracts, 2 carriers) | THE HARTFORD | 478 | $69K |
| Short-term disability(2 contracts, 2 carriers) | THE HARTFORD | 478 | $69K |
| Long-term disability(2 contracts, 2 carriers) | THE HARTFORD | 477 | $63K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 682 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.