| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 436045684 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.49% |
| HYLANT GROUP INC3 | PO BOX 1687 TOLEDO, OH 436031687 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $73 | $2K | 0.95% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 8 CADILLAC DR STE 230 BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $7K | $401 | $8K | 5.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Consulting (general); Insurance services; Direct payment from the plan; Other fees; Contract Administrator Service code 12 | — | $200K |
| JASON FREEMAN AGENT | Other commissions; Other fees; Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | 24 FRANK LLOYD WRIGHT DR STE J4100 ANN ARBOR, MI 48105 | $4K |
| EHIM EIN 38-2776173 TPA | Other fees; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Contract Administrator; Insurance services; Float revenue Service code 12 | — | $1K |
| HYLANT GROUP INC ANN ARBOR AGENCY | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions; Non-monetary compensation; Other fees Service code 22 | PO BOX 541 ANN ARBOR, MI 481060541 | $935 |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MICHIGAN | 389 | $152K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 365 | $169K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 365 | $169K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 365 | $169K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 365 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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.