| 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 | 20.56% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY RICHFIELD, OH 442869381 | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | $7K | — | $7K | 9.58% |
| DENTEMAX5 | 25925 TELEGRAPH ROAD 400 SOUTHFIELD, OH 48033 | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | — | $1K | $1K | 1.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CETERA ADVISOR NETWORKS LLC EIN 30-0588666 INVESTMNET ADVISORY | Investment management Service code 28 | PO BOX 14474 DES MOINES, IA 50306 | $72K |
| USI CONSULTING EIN 06-1053228 ACTUARIAL & RECORDKEEPING | Actuarial; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 11 | 1 SEAGATE STE 2050 TOLEDO, OH 43604 | $49K |
| ASSURED PARTNERS OF OHIO LLC EIN 80-0786940 INSURANCE AGENT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers Service code 15 | 3900 KINROSS LAKES PKWY RICHFIELD, OH 44286 | $42K |
| APPLE GROWTH PARTNERS EIN 81-4504770 ACCOUNTING AUDIT | Accounting (including auditing) Service code 10 | 1540 W MARKET ST AKRON, OH 44313 | $14K |
| BILLINGS & COMPANY CPA'S EIN 34-1818972 ACCOUNTING & TAX PREP | Accounting (including auditing) Service code 10 | 503 ABBE RD S ELYRIA, OH 44035 | $6K |
| CHESTER L SUMPTER & ASSOCIATES LLC EIN 34-1942956 LEGAL SERVICE | Legal Service code 29 | 16927 DETROIT AVE LAKEWOOD, OH 44107 | $350 |
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 | 221 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 7 | $73K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 7 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.