| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE INSURANCE COMPANY | $819 | — | $819 | 10.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMINISTRATORS & CONS. INC CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVE REYNOLDSBURG, OH 43068 | $66K |
| CIGNA HEALTH AND LIFE INS. COMPANY EIN 59-1031071 NETWORK PROVIDER` | Float revenue; Claims processing; Direct payment from the plan; Named fiduciary; Other commissions; Participant communication; Other services; Contract Administrator Service code 12 | — | $18K |
| LABRADOR BROKERAGE AGENCY LLC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 7269 SAWMILL ROAD SUITE 100 DUBLIN, OH 43016 | $17K |
| CO & CO TAX AND ACCOUNTING SERVICES EIN 46-0826164 AUDITOR | Accounting (including auditing) Service code 10 | — | $5K |
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 | 99 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 73 | $472K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY | 99 | $26K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY | 99 | $26K |
| Prescription drug | SUN LIFE ASSURANCE COMPANY OF CANADA | 73 | $472K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 73 | $472K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY | 99 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.