| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $139K | — | $139K | 1.75% |
| DONAVAN GUYLAINE3 | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | PRIORITY HEALTH | $25K | — | $25K | 1.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN, INC. | 220 S. RIDGEWOOD AVENUE DAYTONA BEACH, FL 32114 | FLORIDA HEALTH CARE PLANS, INC. | $35K | — | $35K | 3.57% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 24 FRANK LLOYD WRIGHT DRIVE ANN ARBOR, MI 48106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $31K | — | $31K | 9.29% |
| 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 | $14 | $2K | 3.11% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70 | — | $70 | 0.10% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES-GRAND RAPIDS | 75 REMITTANCE DR STE 1446 CHICAGO, IL 60675 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30 | — | $30 | 0.04% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $808 | — | $808 | 1.85% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES - GRAND RAPIDS | 75 REMITTANCE DR SUITE 1446 CHICAGO, IL 60675 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $384 | — | $384 | 0.88% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 85 CAMPAU AVE. NW SUITE 100 GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $282 | $2 | $284 | 0.65% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH | CUSTOM BENEFIT PROGRAMS INC. 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $232 | — | $232 | 0.53% |
| MACLELLAN, DANIEL, OWEN3 | PO BOX 58434 NASHVILLE, TN 37205 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.12% |
| SINGER, ARTHUR, HOWARD3 | 3150 KAWAI CT SIMI VALLEY, CA 93063 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.12% |
| USI INSURANCE SERVICES LLC3 | DWP/USI OF SO CA INS AGENCY STE 1200 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.06% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP INC. | 85 CAMPAU AVE NW STE 100 GRAND RAPIDS, MI 49503 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $472 | — | $472 | 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 | 977 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 849 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,826 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PRIORITY HEALTH | 1,555 | $10.4M |
| Vision | VISION SERVICE PLAN | 675 | $127K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,933 | $337K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 193 | $44K |
| Other(5 contracts, 5 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,933 | $463K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,933 | — |
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.