| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES M DUSTIN3 Filed as: JAMES M DUSTIN EMPLOYEE BENEFITS | 4700 ROCKSIDE ROAD SUITE 505 CLEVELAND, OH 44131 | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | $573 | $0 | $573 | 0.03% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 4700 ROCKSIDE ROAD SUITE 540 CLEVELAND, OH 44131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $7K | $16K | 8.33% |
| JAMES M DUSTIN3 | 84 BISHOP DRIVE CHAGRIN FALLS, OH 44022 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 7.66% |
| ASSUREDPARTNERS3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 2.51% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE ROAD SUITE 505 CLEVELAND, OH 44131 | AETNA LIFE INSURANCE CO. | $573 | $0 | $573 | 8.50% |
| ASSUREDPARTNERS3 | UNKNOWN LOUISVILLE, KY 40211 | AETNA LIFE INSURANCE CO. | $0 | $6 | $6 | 0.09% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE ROAD SUITE 505 CLEVELAND, OH 44131 | AETNA LIFE INSURANCE CO. | -$595 | $0 | -$595 | -15.24% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 266 | $2.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 140 | $190K |
| Vision(2 contracts) | AETNA LIFE INSURANCE CO. | 65 | $11K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 140 | $190K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 140 | $190K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 140 | $190K |
| Prescription drug | ANTHEM HEALTH PLANS OF KENTUCKY, INC. | 266 | $2.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 140 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.