| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY RICHFIELD, OH 442869381 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | — | $0 | 0.00% |
| MUTUAL HEALTH SERVICES5 | PO BOX 5700 CLEVELAND, OH 44101 | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | — | $15K | $15K | 26.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CETERA ADVISOR NETWORKS LLC EIN 30-0588666 INVESTMENT ADVISORY | Investment management Service code 28 | PO BOX 14474 DES MOINES, IA 50306 | $72K |
| ASSURED PARTNERS OF OHIO LLC EIN 80-0786940 BUSINESS LIABILITY INS | Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers Service code 15 | 3900 KINROSS LAKES PKWY RICHFIELD, OH 44286 | $71K |
| USI CONSULTING EIN 06-1053228 ACTUARIAL & RECORDKEEPING | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Actuarial Service code 11 | 200 N. SAINT CLAIR ST. TOLEDO, OH 43604 | $55K |
| EIDE BAILLY LLP EIN 45-0250958 ACCOUNTING AUDIT | Accounting (including auditing) Service code 10 | 1540 W MARKET ST AKRON, OH 44313 | $16K |
| LPFG LLC EIN 27-1504224 ACCOUNTING & TAX PREP | Accounting (including auditing) Service code 10 | 36901 AMERICAN WAY, STE 7 AVON, OH 44011 | $7K |
| LARRY W SHEPHERD TRUSTEE | Trustee (discretionary) Service code 24 | 1616 DARMOUTH LANE BRUNSWICK, OH 44212 | $5K |
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. |
| 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 5 | $56K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 5 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.