| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $98K | — | $98K | 1.97% |
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $91K | — | $91K | 1.98% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 811 MADISON AVE 8TH FL TOLEDO, OH 43604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 0.64% |
| GRIFFEN, STEVEN3 | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $3K | $23K | 16.01% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES - GRAND RAPIDS | SUITE 1446 75 RMITTANCE DR CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $716 | $9K | 6.52% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $183 | — | $183 | 0.13% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN, STEVE MAY | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 10.22% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES- GRAND RAPIDS | 75 REMITTANCE DR SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $22 | $5K | 4.54% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAMS, INC. | — | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $516 | $2K | 1.35% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $274 | — | $274 | 0.24% |
| ARTHUR HOWARD SINGER3 | 3150 KAWAI CT SIMI VALLEY, CA 93062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $197 | — | $197 | 0.17% |
| HYLANT GROUP INC3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $162 | $8 | $170 | 0.15% |
| DODGE WARREN & PETERS INS SERVICES3 | DWP/USI OF SO CA INS AGCY INC. 21600 OXNARD ST 8TH FL WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.12% |
| LIKENS, DONAL LEE3 | 8833 PERIMETER PARK BLVD 802 JACKSONVILLE, FL 32216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.04% |
| MAYER, ROBERT3 | 54 JANSSEN PL KANSAS CITY, MO 64109 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| DWIGHT L PIERCE3 Filed as: DWIGHT PIERCE | BENEFIT TECHOLOGIES - DIV 10 504 E. 4TH ST ROYAL OAK, MI 48067 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $751 | — | $751 | 10.00% |
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 | 2,029 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 605 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PRIORITY HEALTH | 1,422 | $10.9M |
| Dental | DELTA DENTAL OF MICHIGAN | 3,139 | $793K |
| Vision | SUPERIOR VISION PLAN | 1,514 | $210K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,082 | $607K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 482 | $115K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,082 | $493K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 516 | $255K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,139 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.