| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SCHELLER BRADFORD GROUP3 | 463 OHIO PIKE - STE 303 CINCINNATI, OH 45255 | SUPERIOR DENTAL CARE, INC. | $11K | — | $11K | 5.43% |
| THE SCHELLER BRADFORD GROUP3 | 463 OHIO PIKE - STE 303 CINCINNATI, OH 45255 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 5.50% |
| CBISA REACQUISITION CORP3 | 2101 FLORENCE AVE CINCINNATI, OH 45206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.25% |
| THE SCHELLER BRADFORD GROUP3 | 463 OHIO PIKE - STE 303 CINCINNATI, OH 45255 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| CBISA REACQUISITION CORP3 Filed as: CBISA REACQUISITION CORP. | 2101 FLORENCE AVE CINCINNATI, OH 45206 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $419 | $419 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Other fees; Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $282K |
| THE SCHELLER BRADFORD GROUP NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 463 OHIO PIKE - STE 303 CINCINNATI, OH 45255 | $7K |
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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUPERIOR DENTAL CARE, INC. | 681 | $196K |
| Vision | COMMUNITY INSURANCE COMPANY (G1728) | 249 | $294K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $188K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $155K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (G1728) | 249 | $294K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 681 | — |
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.