| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GUYLAINE D DONAVAN3 Filed as: GUYLAINE D DONOVAN | 811 MADISON AVE TOLEDO, OH 43604 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $10K | $32K | $42K | 7.64% |
| HYLANT GROUP INC3 | PO BOX 541 ANN ARBOR, MI 48106 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $5K | $5K | 0.92% |
| KAREN BARNES3 Filed as: KAREN RENEE BARNES | 811 MADISON AVE TOLEDO, OH 43604 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $940 | $0 | $940 | 0.17% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $1K | $12K | 14.84% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43603 | VISION SERVICE PLAN | $2K | — | $2K | 3.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Contract Administrator; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other fees; Direct payment from the plan Service code 12 | — | $253K |
| MAGELLAN PHARMACY SERVICES, INC EIN 47-5588795 VENDOR | Claims processing Service code 12 | 2520 INDUSTRIAL ROW DR TROY, MI 48084 | $15K |
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 | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 280 | $549K |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 280 | $549K |
| Vision | VISION SERVICE PLAN | 241 | $43K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $80K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $80K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 280 | $549K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.