| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY R SCHREIBMAN3 Filed as: JAY R. SCHREIBMAN LSG INSURANCE PA | 2369 FRANKLIN ROAD BLOOMFIELD HILLS, MI 48302 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $25K | $0 | $25K | 2.98% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE, 8TH FLOOR TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $27K | $1K | $29K | 20.97% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE, 8TH FLOOR TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | $926 | $22K | 20.89% |
| LSG INSURANCE PARTNERS3 Filed as: LSG INSURANCE PARTNERS, INC. | 2600 S. TELEGRAPH ROAD, SUITE 100 BLOOMFIELD HILLS, MI 48302 | NATIONAL VISION ADMINISTRATORS, LLC (NGL) | $4K | $0 | $4K | 5.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE, 8TH FLOOR TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $659 | $7K | 10.99% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVENUE, 8TH FLOOR TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $306 | $4K | 10.81% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE, 8TH FLOOR TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $144 | $15 | $159 | 16.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Insurance services; Float revenue; Contract Administrator; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 12 | — | $834K |
| JAY R. SCHREIBMAN NONE | Non-monetary compensation; Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 2369 FRANKLIN ROAD BLOOMFIELD HILLS, MI 48302 | $29K |
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 | 2,205 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,280 | $830K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,280 | $830K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC (NGL) | 1,588 | $76K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,952 | $67K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 569 | $38K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 2,280 | $830K |
| Other(5 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,952 | $352K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,280 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.