| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON A. FREEMAN3 Filed as: JASON FREEMAN | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $10K | $0 | $10K | 2.21% |
| MARIANNE FARLEY3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $7K | $0 | $7K | 1.67% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CARE NETWORK OF MICHIGAN | $0 | $861 | $861 | 0.20% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | DELTA DENTAL OF MICHIGAN | $2K | $0 | $2K | 5.76% |
| HYLANT GROUP INC3 | 24 FRANK LLOYD WRIGHT DRIVE SUITE J4100 ANN ARBOR, MI 48105 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $447 | $0 | $447 | 6.28% |
| HYLANT GROUP INC3 | 201 DEPOT STREET, SUITE 100 ANN ARBOR, MI 48104 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $350 | $0 | $350 | 10.01% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CARE NETWORK OF MICHIGAN | 83 | $430K |
| Dental | DELTA DENTAL OF MICHIGAN | 93 | $37K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 76 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $3K |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 83 | $430K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.