| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET CHICAGO, IL 60606 | HARTFORD | $0 | $9K | $9K | 1.64% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $16K | $16K | 3.00% |
| C2 CENTRIC LLC3 | POST OFFICE BOX 6824 GRAND RAPIDS, MI 49516 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $5K | $5K | 1.00% |
| UMR, INC.3 Filed as: UMR | 115 WEST WAUSUA AVENUE WAUSUA, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $2K | $2K | 0.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | EYEMED | $5K | — | $5K | 10.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $170 | $1K | 17.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PBM | Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | — | $2.6M |
| UMR EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $103K |
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 | 544 | 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) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL PLAN OF OHIO | 881 | $295K |
| Vision | EYEMED | 730 | $47K |
| Life insurance | HARTFORD | 544 | $567K |
| Long-term disability | HARTFORD | 544 | $567K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 464 | $544K |
| Other(3 contracts, 2 carriers) | HARTFORD | 544 | $604K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 881 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.