| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD D SOMMER3 | 300 WEST WILSON BRIDGE RD STE 300 WORTHINGTON, OH 43085 | MEDICAL MUTUAL OF OHIO | $23K | — | $23K | 3.83% |
| EDWARD D SOMMER3 | 300 W WILSON BRIDGE RD SUITE 300 WORTHINGTON, OH 430852299 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 7.22% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $900 | — | $900 | 6.65% |
| SOMNER, EDWARD3 | 300 WILSON BRIDGE RD, ST 300 WORTHINGTON, OH 43085 | AMERICAN FIDELITY ASSURANCE COMPANY | $592 | — | $592 | 4.37% |
| OHIO AUTO DEALERS ASSN INS3 | TIM DORAN EXEC VP DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $191 | $191 | 1.41% |
| CHANEY GROUP3 | 6059 FRANTZ RD DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | $31 | — | $31 | 0.23% |
No Schedule C service providers reported on this filing.
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 70 | $602K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $49K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $49K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $49K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 33 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.