| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE STREET SUITE 250 COLUMBUS, OH 43215 | COMMUNITY INSURANCE COMPANY | $25K | $0 | $25K | 2.74% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVENUE SUITE 1500 CLEVELAND, OH 44114 | COMMUNITY INSURANCE COMPANY | $17K | $0 | $17K | 1.83% |
| ERC SERVICES INC3 | 387 GOLF VIEW LANE SUITE 100 HIGHLAND HEIGHTS, OH 44143 | COMMUNITY INSURANCE COMPANY | $1K | $0 | $1K | 0.12% |
| CLEARPATH BENEFIT ADVISORS LLC3 | 300 SPRUCE STREET STE 250 COLUMBUS, OH 43215 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 13.40% |
| JEFFERY W JAMES3 | 1917 NEWARK GRANVILLE RD GRANVILLE, OH 43023 | NORTHWESTERN MUTUAL | $2K | $469 | $3K | — |
| KEMELGOR FNCL GRP INC3 | 800 YARD ST SUITE 300 COLUMBUS, OH 43212 | NORTHWESTERN MUTUAL | $364 | $40 | $404 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL BENEFIT ADMINISTRATORS EIN 31-1249371 CONTRACT | Plan Administrator Service code 14 | — | $5K |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 89 | $921K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 104 | $23K |
| Short-term disability | NORTHWESTERN MUTUAL | 0 | $0 |
| Other | HARTFORD LIFE AND ACCIDENT | 104 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.