| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $164K | — | $164K | 1.75% |
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $24K | — | $24K | 1.75% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 24 FRANK LLOYD WRIGHT DRIVE ANN ARBOR, MI 48106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $311 | — | $311 | 0.07% |
| GRIFFEN, STEVEN3 | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 3.74% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.97% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES - GRAND RAPIDS | SUITE 1446 75 RMITTANCE DR CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.60% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES- GRAND RAPIDS | 75 REMITTANCE DR SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $688 | $13K | $13K | 19.76% |
| GRIFFIN, STEVEN, RAY3 Filed as: GRIFFIN, STEVE MAY | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.14% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH | CUSTOM BENEFIT PROGRAMS INC. 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $552 | — | $552 | 0.81% |
| DANIEL OWEN MACLELLAN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.16% |
| ARTHUR HOWARD SINGER3 | 3150 KAWAI CT SIMI VALLEY, CA 93062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.16% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVE NW SUITE 100 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 0.15% |
| USI INSURANCE SERVICES LLC3 | DWP/USI OF SO CA INS AGCY STE 1200 WOODLAND HILS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.10% |
| LIKENS, DONAL LEE3 | 8833 PERIMETER PARK BLVD 802 JACKSONVILLE, FL 32216 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| MAYER, ROBERT3 | 54 JANSSEN PL KANSAS CITY, MO 64109 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
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 | 1,819 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 855 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,674 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | PRIORITY HEALTH | 2,331 | $12.1M |
| Vision | VISION SERVICE PLAN | 900 | $158K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,528 | $503K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 480 | $68K |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,528 | $586K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,528 | — |
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.