| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SOURCE INC3 Filed as: THE BENEFIT SOURCE, INC. | 25700 SCIENCE PARK DRIVE SUITE 130 BEACHWOOD, OH 441227317 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $286K | $286K | 3.86% |
| SAVIN SALES ASSOCIATES INC3 Filed as: SAVIN SALES ASSOCIATES, INC. | 8110 CHAGRIN ROAD CHAGRIN FALLS, OH 440234744 | UNITEDHEALTHCARE INSURANCE COMPANY | $95K | — | $95K | 1.29% |
| MARK J. SAMAR3 | 31755 FAIRMONT BLVD. #200 PAPPER PIKE, OH 44124 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $102K | — | $102K | 10.88% |
| NEXT GENERATION ENROLLMENT INC.3 Filed as: NEXT GENERATION ENROLLMENT, INC. | 455 PETTIS AVENUE SE P O BOX 527 ADA, MI 49301 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 0.85% |
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 | 1,249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,480 | $7.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,248 | $941K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,480 | — |
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.
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.