| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMILY G POE3 Filed as: EMILY POE | PO BOX 261 CHILLICOTHE, OH 45601 | NATIONWIDE LIFE INSURANCE COMPANY | — | $5K | $5K | — |
| THE EMPLOYEE BENEFIT SERVICE CENTER3 Filed as: EMPLOYEE BENEFITS SERVICE CENTER | 4430 KANAWHA TURNPIKE SOUTH CHARLESTON, WV 25309 | SIRIUS AMERICA INSURANCE COMPANY | — | $29K | $29K | — |
| GERBER INSURANCE SERVICES3 | 382 ARCH ST CHILLICOTHE, OH 45601 | SIRIUS AMERICA INSURANCE COMPANY | $18K | — | $18K | — |
| S&S HEALTH CARE3 | 1585 KEMPER MEADOW DR CINCINNATI, OH 45240 | SIRIUS AMERICA INSURANCE COMPANY | — | $15K | $15K | — |
| QUALITY CARE PARTNERS5 | 2806 BELL ST ZANESVILLE, OH 43701 | SIRIUS AMERICA INSURANCE COMPANY | — | $5K | $5K | — |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIRIUS AMERICA INSURANCE COMPANY | 79 | $0 |
| Dental | NATIONWIDE LIFE INSURANCE COMPANY | 119 | $0 |
| Vision | NATIONWIDE LIFE INSURANCE COMPANY | 119 | $0 |
| Life insurance | NATIONWIDE LIFE INSURANCE COMPANY | 119 | $0 |
| Other | NATIONWIDE LIFE INSURANCE COMPANY | 119 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.