| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INDEMNITY GROUP LLC3 Filed as: THE INDEMNITY GROUP | 3628 WALNUT HILLS ROAD SUITE 200 ORANGE VILLAGE, OH 44122 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $116K | $116K | 2.25% |
| MARK J. SAMAR3 | 31755 FAIRMONT BLVD. PAPPER PIKE, OH 44124 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $41K | — | $41K | 5.97% |
| 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 | $4K | — | $4K | 0.54% |
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 | 786 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 478 | $5.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 756 | $688K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 756 | — |
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.