| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PLANCORP VANTAGE BENEFIT ADVISORS3 | 6200 ROCKSIDE RD INDEPENDENCE, OH 44131 | MEDICAL MUTUAL OF OHIO | $23K | $2K | $25K | 2.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: WALSH DUFFIELD COMPANIES INC. | 726 EXCHANGE STREET SUITE 200 BUFFALO, NY 14210 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $0 | $23K | 5.86% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DR CTR II STE305 ELMWOOD PARK, NJ 07407 | HARTFORD LIFE AND ACCIDENT | $4K | $9K | $13K | 7.37% |
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 | 566 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 566 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERA HEALTHCARE | 157 | $2.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $388K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $388K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 566 | $564K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $388K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 389 | $388K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERA HEALTHCARE | 157 | $2.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 566 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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."
No prospect flags tripped on this filing.