| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MILLER LEWIS INSURANCE AGENCY3 | P.O. BOX 368 LANCASTER, OH 431300368 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WESTPORT INSURANCE COMPANY EIN 48-0921045 STOP LOSS CARRIER | Insurance services Service code 23 | — | $98K |
| EMPLOYEE BENEFIT MANAGEMENT CORP EIN 31-0747539 THIRD PARTY ADMINISTRATOR | Insurance brokerage commissions and fees; Contract Administrator Service code 13 | — | $51K |
| OSU MANAGED CARE EIN 31-1372469 PPO | Other fees Service code 99 | — | $22K |
| MILLER LEWIS INSURANCE AGENCY EIN 31-1281271 BROKER | Insurance agents and brokers Service code 22 | — | $19K |
| EMPLOYEE BENEFIT MANAGMENT CORP | Other commissions; Insurance brokerage commissions and fees Service code 53 | — | $18K |
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 | 139 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 186 | $34K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 186 | $34K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 186 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.