| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY STE 300 RICHFIELD, OH 44286 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS BENEFIT ADVISORS | 10 NORTH PARK #200 HUNT VALLEY, MD 21030 | EYEMED VISION CARE | $3K | — | $3K | 12.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Claims processing; Float revenue; Direct payment from the plan; Other fees Service code 12 | — | $410K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $71K |
| ASSUREDPARTNERS OF OHIO LLC BROKER | Other commissions Service code 55 | 3900 KINROSS LAKES PKWY STE 300 RICHFIELD, OH 44286 | $54K |
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 | 238 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUPERIOR DENTAL CARE, INC | 388 | $0 |
| Vision | EYEMED VISION CARE | 332 | $25K |
| Life insurance | STANDARD INSURANCE COMPANY | 238 | $42K |
| Short-term disability | STANDARD INSURANCE COMPANY | 238 | $42K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 173 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.