| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE EMPLOYEE BENEFIT SERVICE CENTER3 | 4430 KANAWHA TURNPIKE SOUTH CHARLESTON, WV 25309 | UNITED STATE FIRE INSURANCE COMPANY | — | $29K | $29K | 13.72% |
| TAH BENEFITS3 | 5007 PINE CREEK DR. WESTERVILLE, OH 43081 | UNITED STATE FIRE INSURANCE COMPANY | $28K | — | $28K | 13.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 NONE | Other fees; Contract Administrator; Claims processing Service code 12 | P.O. BOX 632328 CINCINNATI, OH 452632328 | $20K |
| MEDICAL BENEFITS ADMINISTRATORS EIN 31-1249371 NONE | Plan Administrator Service code 14 | — | $14K |
| TABIT, ARGANBRIGHT & HAZELBAKER EIN 31-0878270 NONE | Insurance agents and brokers Service code 22 | — | $11K |
| CLINIX NONE | Claims processing; Contract Administrator Service code 12 | 3492 SNOUFFER ROAD, SUITE 200 CINCINNATI, OH 43235 | $3K |
| MEDICAL BENEFITS MUTUAL LIFE INS. C EIN 31-4210910 NONE | Plan Administrator Service code 14 | — | $3K |
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. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED STATE FIRE INSURANCE COMPANY | 119 | $210K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED STATE FIRE INSURANCE COMPANY | 119 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.