| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD STREET COLUMBUS, OH 43212 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 3.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST COLUMBUS, OH 43212 | AETNA LIFE INSURANCE CO. | $35K | — | $35K | 7.30% |
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PKWY E BIRMINGHAM, AL 35244 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | $7K | $17K | 25.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $391K |
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $88K |
| DELTA DENTAL OF OHIO EIN 31-0685339 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $46K |
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 NONE | Actuarial Service code 11 | — | $14K |
| ARY ROEPCKE MULCHAEY, P.C. EIN 52-2370901 NONE | Accounting (including auditing) Service code 10 | — | $10K |
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 | 1,150 | 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) | 1,150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 938 | $104K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,594 | $479K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 1,594 | $479K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 1,594 | $479K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,089 | $703K |
| Other | AETNA LIFE INSURANCE CO. | 1,594 | $479K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,594 | — |
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.