| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOW, IL 60008 | ANTHEM LIFE INSURANCE COMPANY | $30K | $6K | $37K | 15.86% |
| SHAWAN MARQUIS AGENCY INC3 | 110 EAST WILSON BRIDGE ROAD SUITE 260 COLUMBUS, OH 43085 | ANTHEM LIFE INSURANCE COMPANY | $2K | $2K | $4K | 1.73% |
| ANDREW INSURANCE ASSOCIATES INC3 Filed as: ANDREW INSURANCE ASSOCIATES IN | 9912 BREWSTER LANE POWELL, OH 43065 | ANTHEM LIFE INSURANCE COMPANY | $355 | — | $355 | 0.15% |
| JAMES DASHER3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $7K | — | $7K | 5.60% |
| SUSAN STRAIT3 | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $521 | — | $521 | 0.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 201 EAST 4TH STREET SUITE 625 CINCINNATI, OH 45202 | VISION SERVICE PLAN | $1K | — | $1K | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $307 | — | $307 | 0.90% |
| ANDREW INSURANCE ASSOCIATES INC3 Filed as: ANDREW INSURANCE ASSOCIATES | 9912 BREWSTER LANE POWELL, OH 43065 | VISION SERVICE PLAN | $1 | — | $1 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 303 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 230 | $3.5M |
| Dental | DELTA DENTAL OF OHIO | 468 | $124K |
| Vision(2 contracts, 2 carriers) | COMMUNITY INSURANCE COMPANY | 230 | $3.6M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 281 | $231K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 281 | $231K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 281 | $231K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 281 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.