Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe primary carrier changed from the prior filing. The plan has shown it will move. Pitch it again on the next cycle.
Broker compensation exceeds 5% of premium. This is a small-plan minimum fee or a costly broker setup that a competing bid can beat.
The top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Custom Benefit Consultants, Inc. Stop-loss | Stop-loss |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 1 contract with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 109 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 333 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 730 | $454K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 730 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: United States Fire Insurance Company | |
Carrier: United States Fire Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN BENEFIT CORPORATION EIN 55-0672859 THIRD PARTY ADMINISTRATOR | Contract Administrator; Consulting (general); Recordkeeping fees; Direct payment from the plan; Claims processing Service code 12 | 9200 US ROUTE 60 ONA, WV 25545 | $129K |
| NORTHWESTERN OHIO ADMINISTRATORS EIN 34-1337680 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing; Direct payment from the plan; Recordkeeping fees; Consulting (general) Service code 12 | P.O. BOX 1298 MAUMEE, OH 43537 | $104K |
| ALLOTTA, FARLEY & CO., LPA EIN 34-1316963 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3240 LEVIS COMMONS BLVD. PERRYSBURG, OH 43551 | $73K |
| DENISE MANN EIN 23-7404076 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | P.O. BOX 638 NORWALK, OH 44857 | $61K |
| SEGAL CONSULTING EIN 13-1975125 CONSULTANT, ACTUARY | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | 1111 SUPERIOR AVE 2340 CHICAGO, IL 60606 | $53K |
| PNC BANK EIN 22-1146430 INVESTMENT MANAGER | Custodial (other than securities); Soft dollars commissions; Custodial (securities); Investment management Service code 18 | 1900 E 9TH STREET CLEVELAND, OH 44114 | $48K |
| PAYNE NICKLES & CO. EIN 34-1664586 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 257 BENEDICT AVE, BLDG D NORWALK, OH 44857 | $36K |
| COSTCO HEALTH SOLUTIONS, INC. EIN 81-2865195 ADMINISTRATIVE SERVICES | Direct payment from the plan; Claims processing; Recordkeeping fees Service code 12 | 999 LAKE DRIVE ISSAQUAH, WA 98027 | $26K |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
1 contact
10 filings · 2016 to 2025