| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | STANDARD INSURANCE COMPANY | $37K | $18K | $55K | 5.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $7K | $0 | $7K | 0.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIM ADMIN | Claims processing Service code 12 | — | $639K |
| USI INSURANCE SERVICES LLC EIN 13-3771734 CONSULTING SERVICES | Consulting (general) Service code 16 | — | $200K |
| STANDARD LIFE INSURANCE EIN 93-0242990 STD INS SERVICES | Insurance services Service code 23 | — | $62K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIM ADMIN | Claims processing Service code 12 | — | $51K |
| OPTUM FINANCIAL INC ADMIN SERVICES | Plan Administrator Service code 14 | 2771 MOMENTUM PLACE CHICAGO, IL 60689 | $11K |
| PIVOT CPAS EIN 20-0708248 AUDIT SERVICES | Accounting (including auditing) Service code 10 | — | $11K |
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 | 1,937 | 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) | 1,937 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | STANDARD INSURANCE COMPANY | 1,937 | $1.0M |
| Life insurance | STANDARD INSURANCE COMPANY | 1,937 | $1.0M |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,937 | $1.0M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,298 | $1.7M |
| Other | STANDARD INSURANCE COMPANY | 1,937 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,937 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.