| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 409 EAST MONUMENT AVENUE, SUITE 400 DAYTON, OH 45402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $680 | $9K | 9.38% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | AFLAC | $2K | $27 | $2K | 5.97% |
| ALISON L PFEIFFER3 Filed as: ALISON L. PFEIFFER | 377 CLEAR SPRINGS COURT CARLISLE, OH 45005 | AFLAC | $1K | $50 | $1K | 3.83% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 EAST MONUMENT AVENUE, SUITE 400 DAYTON, OH 45402 | AFLAC | $861 | — | $861 | 2.21% |
| MARTY SCHWARTZ3 | 02662 STATE ROUTE 197 SAINT MARYS, OH 45885 | AFLAC | $578 | — | $578 | 1.49% |
| CLEVELAND S MCCALLISTER3 | 30 MACY STREET DAYTON, OH 45415 | AFLAC | $217 | — | $217 | 0.56% |
| GINA GEIGER ENTERPRISES LLC3 | 6680 POE AVENUE, SUITE 400 DAYTON, OH 45414 | AFLAC | $202 | $10 | $212 | 0.55% |
| MICHAEL R REBER3 | 20101 HERON CROSSING DRIVE TAMPA, FL 33647 | AFLAC | $180 | — | $180 | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $126K |
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 | 635 | 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) | 635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUPERIOR DENTAL CARE, INC. | 478 | $118K |
| Vision | EYEMED | 404 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $99K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $99K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 348 | $339K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 635 | — |
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.