| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ROMIG AGENCY INC3 Filed as: THE ROMIG AGENCY | 316 E 3RD STREET UHRICHSVILLE, OH 446831823 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 1.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VISION SERVICE PLAN EIN 31-0725743 ADMINISTRATOR | Plan Administrator; Contract Administrator Service code 13 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $30K |
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 | 443 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 443 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,352 | $347K |
| Vision | VISION SERVICE PLAN | 443 | $85K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 770 | $0 |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 486 | $0 |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 630 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,352 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.