| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARY JO LEFEVRE3 | 2401 W. BIG BEAVER SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $33K | — | $33K | 4.61% |
| ACTION BENEFITS COMPANY3 Filed as: ACTION BENEFITS | 24600 NORTHWESTERN HWY SOUTHFIELD, MI 48075 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 1.06% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | P.O. BOX 541 ANN ARBOR, MI 48106 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $1K | $1K | 0.16% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 8 CADILLAC DRIVE SUITE 230 BRENTWOOD, TN 37027 | DELTA DENTAL OF MICHIGAN | $6K | — | $6K | 10.05% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVE TOLEDO, OH 43604 | STANDARD INSURANCE COMPANY | $1K | $96 | $1K | 5.58% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVE TOLEDO, OH 43604 | STANDARD INSURANCE COMPANY | $961 | $86 | $1K | 5.43% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVE TOLEDO, OH 43604 | STANDARD INSURANCE COMPANY | $899 | $79 | $978 | 5.32% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | NATIONAL VISION ADMINISTRATORS, LLC | $873 | — | $873 | 10.00% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVE TOLEDO, OH 43604 | STANDARD INSURANCE COMPANY | $1K | $21 | $1K | 23.49% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 173 | $721K |
| Dental | DELTA DENTAL OF MICHIGAN | 144 | $58K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 134 | $9K |
| Life insurance | STANDARD INSURANCE COMPANY | 112 | $19K |
| Short-term disability | STANDARD INSURANCE COMPANY | 112 | $21K |
| Long-term disability | STANDARD INSURANCE COMPANY | 112 | $18K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 173 | $721K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.