| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD ST COLUMBUS, OH 43212 | AETNA LIFE INSURANCE COMPANY | — | $3K | $3K | 0.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PL CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $566 | $7K | 15.43% |
| SEIBERT KECK INSURANCE AGENCY3 | 2950 W MARKET ST AKRON, OH 44333 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16 | — | $16 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC. CLEVELAND | 93245 NETWORK PLACE CHICAGO, IL 60673 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 9.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SERVICES OF GA INC. | 1 GLENLAKE PKWY 11TH FLOOR ATLANTA, GA 30328 | HUMANA INSURANCE COMPANY | — | $300 | $300 | 0.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC CLEVELAND | 93245 NETWORK PLACE CHICAGO, IL 60673 | COMPBENEFITS INSURANCE COMPANY | $1K | — | $1K | 9.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SERVICES OF GA INC. | 1 GLENLAKE PKWY 11TH FLOOR ATLANTA, GA 30328 | COMPBENEFITS INSURANCE COMPANY | — | $201 | $201 | 1.55% |
| SEIBERT KECK INSURANCE AGENCY3 | 2950 W MARKET ST AKRON, OH 44333 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 1.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 93245 NETWORK PL CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $5 | $47 | 1.19% |
No Schedule C service providers reported on this filing.
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 208 | $781K |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 60 | $47K |
| Vision | COMPBENEFITS INSURANCE COMPANY | 60 | $13K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $44K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $44K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.