| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMUNITY INSURANCE COMPANY5 Filed as: COMMUNITY INSURANCE COMPANY, DBA | ANTHEM BLUE CROSS AND BLUE SHIELD 4361 IRWIN SIMPSON ROAD MASON, OH 45040 | COMMUNITY INSURANCE COMPANY | — | $1.8M | $1.8M | 130.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $613K |
| SEGAL COMPANY MIDWEST EIN 13-1975125 NONE | Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $194K |
| FAULKNER, HOFFMAN & PHILLIPS, LLP EIN 34-1909706 NONE | Legal; Direct payment from the plan Service code 29 | — | $165K |
| PENNY BROWN EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| IWDC OF SO OH PENSION TRUST EIN 31-6038516 RELATED FUND | Direct payment from the plan; Plan Administrator Service code 14 | — | $77K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $77K |
| OVERMYER HALL ASSOCIATES NONE | Insurance services; Direct payment from the plan; Insurance agents and brokers Service code 22 | 1600 W LANE AVE, SUITE 200 COLUMBUS, OH 43221 | $76K |
| CLARK, SCHAEFER, HACKETT & CO. EIN 31-0800053 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $55K |
| PITNEY BOWES, INC. NONE | Direct payment from the plan; Other services Service code 49 | 3001 SUMMER ST. STAMFORD, CT 06926 | $43K |
| PEGGY GOTTHARDT EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| NATHAN DANIELS EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $39K |
| LINDA BUTCHER EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| CYNTHIA SCHINDEL EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| OLIVIA OVERMEYER EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| MARIANNE RUSE EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| AIME COCHRAN EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| MARY YODER EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| KAY DAVIS EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| BRIGID DUNCAN EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| KEY TRUST COMPANY EIN 31-0466650 NONE | Direct payment from the plan; Custodial (securities); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $27K |
| OHIO VALLEY PAINTING NONE | Other services; Direct payment from the plan Service code 49 | 270 VERMONT AVE DAYTON, OH 45402 | $24K |
| HOUSER INC NONE | Direct payment from the plan; Other services Service code 49 | 851 S. PATTERSON BLVD DAYTON, OH 45402 | $24K |
| TOBE LAWN CARE EIN 20-8222472 NONE | Direct payment from the plan; Other services Service code 49 | — | $22K |
| RIECK SERVICES EIN 05-0602227 NONE | Other services; Direct payment from the plan Service code 49 | — | $21K |
| DAYTON POWER AND LIGHT COMPANY EIN 31-0258470 NONE | Direct payment from the plan; Other services Service code 49 | — | $18K |
| BOONE RESTORATION NONE | Other services; Direct payment from the plan Service code 49 | 4500 W. WEGNER RD. CLAYTON, OH 45315 | $15K |
| DELK, RUTHERFORD & ASSOCIATES EIN 32-0036374 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $15K |
| CINCINNATI BELL EIN 31-1056105 NONE | Other services; Direct payment from the plan Service code 49 | — | $13K |
| VOLO TECHNOLOGIES EIN 27-0648178 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $12K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $10K |
| WIGGINS CLEANING & CARPET SERVICES NONE | Direct payment from the plan; Other services Service code 49 | 4699 SALEM AVE., BLDG. 2 DAYTON, OH 45416 | $10K |
| EARLY EXPRESS NONE | Other services; Direct payment from the plan Service code 49 | 1333 EAST SECOND ST. DAYTON, OH 45401 | $8K |
| CRAIG WANNER EIN 31-0557391 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $8K |
| CINTAS CORPORATION NONE | Direct payment from the plan; Other services Service code 49 | 6800 CINTAS BLVD MASON, OH 45040 | $8K |
| THE NORTHERN TRUST COMPANY EIN 36-7612041 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $7K |
| AUTOMATIC DATA PROCESSING EIN 22-3006057 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
| NATIONAL COORDINATING COMMITTEE-MEP NONE | Other services; Direct payment from the plan Service code 49 | 815 16TH STREET NW, 6TH FLOOR WASHINGTON, DC 20006 | $6K |
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 | 3,171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2,275 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 6,605 | $56K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 4,355 | $1.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 3,090 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,605 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.