| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTH COST SOLUTIONS, INC.3 Filed as: HEALTH COST SOLUTIONS | PO BOX 1439 HENDERSONVILLE, TN 37077 | PHOENIX EXCESS RISK/GERBER LIFE INSURANCE COMPANY | $20K | — | $20K | 11.11% |
| HYLANT GROUP INC3 | 8 CADILLAC DRIVE SUITE 230 BRENTWOOD, TN 37027 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $740 | $7K | 6.75% |
| HYLANT GROUP INC3 | 85 CAMPAU AVE NW SUITE 100 GRAND RAPIDS, MI 49503 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.97% |
| HYLANT GROUP INC3 | 8 CADILLAC SUITE 230 BRENTWOOD, TN 37027 | RELIANCE STANDARD INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| HYLANT GROUP INC3 | 8 CADILLAC SUITE 230 BRENTWOOD, TN 37027 | RELIANCE STANDARD INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 436045684 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $373 | $1K | 11.75% |
| HYLANT GROUP INC3 | 8 CADILLAC DR SUITE 230 BRENTWOOD, TN 37027 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $787 | $26 | $813 | 12.70% |
| HYLANT GROUP INC3 | 750 OLD HICKORY BLVD SUITE 2-275 BRENTWOOD, TN 37027 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $173 | — | $173 | 2.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RISK SOLUTIONS CAPTIVE EIN 46-3092480 CAPTIVE | Insurance services Service code 23 | PO BOX 1439 HENDERSONVILLE, TN 37077 | $457K |
| HEALTH COST SOLUTIONS EIN 62-1115925 CLAIM ADMINISTRATOR | Claims processing; Other services Service code 12 | PO BOX 1439 HENDERSONVILLE, TN 37077 | $84K |
| CIGNA EIN 59-1031071 PPO NETWORK | Other insurance fees and expenses Service code 73 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $20K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 CASE MANAGEMENT | Other insurance fees and expenses Service code 73 | — | $4K |
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 | 262 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 152 | $119K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 152 | $108K |
| Life insurance(2 contracts) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 152 | $114K |
| Short-term disability | RELIANCE STANDARD INSURANCE COMPANY | 147 | $14K |
| Long-term disability | RELIANCE STANDARD INSURANCE COMPANY | 147 | $18K |
| Stop-loss / reinsurancereinsurance | PHOENIX EXCESS RISK/GERBER LIFE INSURANCE COMPANY | 123 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.