| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | DELTA DENTAL | $5K | — | $5K | 1.68% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN BRABENDER, INC. | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | CIGNA | $16K | — | $16K | 6.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY MUTUAL COMPANY EIN 31-1440175 NONE | Claims processing; Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $274K |
| EXPRESS SCRIPTS EIN 31-1714795 NONE | Other fees; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $18K |
| MARSH & MCLENNAN AGENCY EIN 26-3237576 NONE | Non-monetary compensation; Insurance agents and brokers; Other commissions Service code 22 | — | $0 |
| MCGOHAN BRABENDER, INC. EIN 31-1191330 NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 3931 SOUTH DIXIE DRIVE DAYTON, OH 45439 | $0 |
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 | 458 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 863 | $300K |
| Life insurance | CIGNA | 458 | $239K |
| Short-term disability | CIGNA | 458 | $239K |
| Long-term disability | CIGNA | 458 | $239K |
| Stop-loss / reinsurancereinsurance | ANTHEM | 793 | $529K |
| Other | CIGNA | 458 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 863 | — |
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.