| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARY JO LEFEVRE3 | 2401 BIG BEAVER ROAD, SUITE 400 TROY, MI 78084 | BLUE CROSS BLUE SHIELD MICHIGAN | $47K | $0 | $47K | 1.12% |
| HYLANT GROUP INC3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | BLUE CROSS BLUE SHIELD MICHIGAN | $0 | $16K | $16K | 0.38% |
| MICHELLE R. STOUFFER3 Filed as: MICHELLE R STOUFFER | 140 MONROE CENTER STREET NW SUITE 20 GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD MICHIGAN | $2K | $0 | $2K | 0.04% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43604 | METROPOLITAN LIFE INSURANCE COMPANY | $54K | $13 | $54K | 9.77% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES OF MI LLC | PO BOX 510187 NEW BERLIN, WI 53151 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 0.97% |
| HYLANT GROUP INC3 | 811 MADISON AVENUE TOLEDO, OH 43603 | VISION SERVICE PLAN | $6K | $0 | $6K | 8.42% |
| HNI RISK SERVICES3 | 140 MONROE CENTER STREET NW SUITE 200 GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.59% |
| HYLANT GROUP INC3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $495 | $2K | 15.45% |
| HNI RISK SERVICES3 | PO BOX 510187 NEW BERLIN, WI 53151 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $426 | $0 | $426 | 2.80% |
| HYLANT GROUP INC3 | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | HERITAGE VISION PLANS INC | $718 | — | $718 | 7.38% |
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 | 390 | 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) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD MICHIGAN | 785 | $4.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 820 | $553K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 291 | $80K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 820 | $553K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 67 | $15K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 820 | $553K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 820 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.