| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY DBA BROWER | 409 MONUMENT AVENUE, SUITE 400 DAYTON, OH 45402 | HCC LIFE INSURANCE GROUP | $37K | — | $37K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC DBA TRI | 2300 RENAISSANCE BLVD KING OR PRUSSIA, PA 19406 | HCC LIFE INSURANCE GROUP | $18K | $220 | $19K | 5.06% |
| RXBENEFITS, INC.5 Filed as: RXBENEFITS | 3500 BLUE LAKE DRIVE, SUITE 200 BIRMINGHAM, AL 35243 | RXBENEFITS | — | $9K | $9K | 3.73% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 409 EAST MONUMENT AVENUE, SUITE 400 DAYTON, OH 45402 | SUPERIOR DENTAL CARE, INC. | $6K | — | $6K | 6.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 409 EAST MONUMENT AVENUE, SUITE 400 DAYTON, OH 45402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $14K | $23K | 25.79% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GRP A MARSH & MCLENNAN, AGCY | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | ALLSTATE | $3K | — | $3K | 4.21% |
| PHILLIP N MCKELVEY3 | 10355 RIVERWALK LANE LOVELAND, OH 45140 | ALLSTATE | $2K | — | $2K | 3.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $163K |
| MARSH & MCLENNAN AGENCY EIN 26-3237576 BROKER | Other commissions Service code 55 | 409 EAST MONUMENT AVENUE, SUITE 400 DAYTON, OH 45385 | $13K |
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 | 228 | 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) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUPERIOR DENTAL CARE, INC. | 387 | $97K |
| Vision | VISION SERVICE PLAN | 238 | $46K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $90K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $160K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $90K |
| Prescription drug | RXBENEFITS | 225 | $229K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE GROUP | 223 | $369K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 345 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.