| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | COMMUNITY INSURANCE COMPANY | $30K | $2K | $32K | 3.56% |
| BROWER INSURANCE AGENCY LLC3 | PO BOX 37 DAYTON, OH 45401 | COMMUNITY INSURANCE COMPANY | $0 | $3K | $3K | 0.28% |
| BENEFITS NETWORK INSURANCE AGENCY3 | 4555 LAKE FOREST DR STE 510 CINCINNATI, OH 45242 | COMMUNITY INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | UNITED OF OMAHA INSURANCE COMPANY | $7K | $4K | $11K | 22.05% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | SUPERIOR DENTAL CARE, INC. | $3K | $0 | $3K | 6.96% |
| MARSH & MCLENNAN AGENCY LLC3 | 409 E MONUMENT AVE STE 400 DAYTON, OH 45402 | EYEMED VISION CARE | $916 | $0 | $916 | 10.06% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 139 | $909K |
| Dental | SUPERIOR DENTAL CARE, INC. | 181 | $45K |
| Vision | EYEMED VISION CARE | 132 | $9K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA INSURANCE COMPANY | 110 | $50K |
| Short-term disability | UNITED OF OMAHA INSURANCE COMPANY | 86 | $50K |
| Long-term disability | UNITED OF OMAHA INSURANCE COMPANY | 86 | $50K |
| Prescription drug | COMMUNITY INSURANCE COMPANY | 139 | $909K |
| Other(2 contracts, 2 carriers) | ANTHEM | 110 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.