| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE GROUP3 Filed as: INSURANCE SERVICES, LLC | PO BOX 1280 GRUNDY, VA 24614 | UNITEDHEALTHCARE INSURANCE COMPANY | $23K | $0 | $23K | 2.44% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 811 MADISON AVENUE TOLEDO, OH 43604 | UNITEDHEALTHCARE INSURANCE COMPANY | $12K | $0 | $12K | 1.27% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INSURANCE SVCS SOUTHEAST | 4321 EAST 60TH STREET DAVENPORT, IA 52807 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | $0 | $7K | 0.70% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP | 24 FRANK LLOYD WRIGHT DRIVE SUITE J4100 ANN ARBOR, MI 48106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $495 | $0 | $495 | 11.59% |
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 | 88 | 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) | 88 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $946K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $946K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $946K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 88 | $4K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 88 | $4K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 88 | $4K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 128 | $946K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 88 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.