| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BAC AGENCY, INC.5 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESS ADMIN. & CONS., INC. THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 6331 EAST LIVINGSTON AVENUE REYNOLDSBURG, OH 43068 | $70K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NETWORK PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $23K |
| USI INSURANCE SERVICES LLC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 711 EAST MAIN STREET #201 CHICOPEE, MA 01020 | $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 | 187 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 127 | $155K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 243 | $54K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 243 | $54K |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 243 | $54K |
| Prescription drug(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 127 | $155K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 127 | $155K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 243 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.