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 broker changed. The plan may listen to a new pitch.
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 Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 12 contracts 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 | 467 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 467 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 467 | $142K |
| Vision | VISION BENEFITS OF AMERICA | 259 | $16K |
| Life insurance(5 contracts) | PRUDENTIAL | 375 | $112K |
| Short-term disability(3 contracts) | PRUDENTIAL | 375 | $29K |
| Long-term disability | PRUDENTIAL | 375 | $35K |
| Other | PRUDENTIAL | 111 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | - |
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.
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROUNDSTONE MAN. EIN 27-0371422 STOP LOSS | Claims processing Service code 12 | 19621 LAKE ROAD ROCKY RIVER, OH 44116 | $810K |
| C.A.S. EIN 91-1991574 TPA | Plan Administrator Service code 14 | — | $91K |
| S&S HEALTHCARE EIN 31-1418743 PPO NETWORK | Claims processing Service code 12 | 4900 PARKWAY DRIVE SUITE 160 MASON, OH 45040 | $60K |
| GILBERT INC. AGENCY EIN 25-0943703 BROKER | Insurance agents and brokers Service code 22 | 30 EAST STATE STREET SHARON, PA 16146 | $52K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 TELEMEDICINE | Claims processing Service code 12 | 7400 W CAMPUS RD F510 NEW ALBANY, OH 43054 | $6K |
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.
3 contacts
Phone and email for the top hat administrator are on Pro.
11 filings · 2015 to 2025