| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $171K | — | $171K | 1.99% |
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $33K | — | $33K | 2.03% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 8 CADILLAC DR. STE 230 BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 0.23% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 24 FRANK LLOYD WRIGHT DRIVE ANN ARBOR, MI 48106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 1.78% |
| GRIFFEN, STEVEN3 | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.11% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES - GRAND RAPIDS | SUITE 1446 75 RMITTANCE DR CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.76% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $62 | $1K | 1.40% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN, STEVE MAY | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.24% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH | CUSTOM BENEFIT PROGRAMS INC. 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $829 | $449 | $1K | 1.37% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES- GRAND RAPIDS | 75 REMITTANCE DR SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.10% |
| HYLANT GROUP INC3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $386 | $16 | $402 | 0.43% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $227 | — | $227 | 0.24% |
| ARTHUR HOWARD SINGER3 | 3150 KAWAI CT SIMI VALLEY, CA 93062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 0.16% |
| USI INSURANCE SERVICES LLC3 | DWP/USI OF SO CA INS AGCY STE 1200 WOODLAND HILS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $118 | — | $118 | 0.13% |
| LIKENS, DONAL LEE3 | 8833 PERIMETER PARK BLVD 802 JACKSONVILLE, FL 32216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.07% |
| MAYER, ROBERT3 | 54 JANSSEN PL KANSAS CITY, MO 64109 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.03% |
| 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 | $8 | — | $8 | 0.01% |
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 | 1,699 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 579 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PRIORITY HEALTH | 2,361 | $11.4M |
| Dental | DELTA DENTAL OF MICHIGAN | 3,243 | $871K |
| Vision | VISION SERVICE PLAN | 819 | $139K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,093 | $468K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 373 | $93K |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,093 | $575K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,243 | — |
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.