| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | DELTA DENTAL OF OHIO | $28K | — | $28K | 0.34% |
| FRANK FIORE3 | 6825 GULF OF MEXICO DRIVE LONGBOAT KEY, FL 34228 | DELTA DENTAL OF OHIO | $12K | — | $12K | 0.15% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | — | $22K | 1.00% |
| FRANK FIORE3 | 6825 GULF OF MEXICO DRIVE LONGBOAT KEY, FL 34228 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 0.63% |
| FRANK FIORE3 | 6825 GULF OF MEXICO DRIVE LONGBOAT KEY, FL 34228 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 1.28% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS PROCESSOR | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1351 WM. HOWARD TAFT RD CINCINNATI, OH 45206 | $5.1M |
| CVS PHARMACY, INC. EIN 05-0340626 CLAIMS PROCESSOR | Claims processing Service code 12 | 1 CVS DR WOONSOCKET, RI 02895 | $402K |
| LIFE INSURANCE COMPANY OF NORTH AME EIN 23-1503749 CLAIMS PROCESSOR | Claims processing Service code 12 | 900 COTTAGE GROVE ROAD HARTFORD, CT 06152 | $0 |
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 | 18,860 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,017 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 19,877 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 29,794 | $8.2M |
| Vision | FIDELITY SECURITY INSURANCE COMPANY | 23,284 | $1.9M |
| Life insurance(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 18,894 | $1.6M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 14,918 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 29,794 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.