| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMINISTRATORS & CONS. INC CONTRACT ADMIN. | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | $111K |
| LABRADOR BROKERAGE AGENCY INSURANCE AGENT | Insurance agents and brokers Service code 22 | 7269 SAWMILL ROAD SUITE 100 DUBLIN, OH 43016 | $59K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NETWORK PROVIDER | Insurance services Service code 23 | — | $37K |
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 | 201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIMERICA INSURANCE COMPANY | 201 | $373K |
| Prescription drug | UNIMERICA INSURANCE COMPANY | 201 | $373K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 201 | $373K |
| Other | UNITED HEALTHCARE | 201 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.