| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | COMMUNITY INSURANCE COMPANY | $224 | — | $224 | 0.25% |
| MCGOWAN/BRABENDER AGENCY3 | 3931 S DIXIE DRIVE DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $435 | $435 | 1.10% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | -$217 | -$217 | -0.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S DIXIE DRIVE DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $224 | $224 | 1.11% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | -$112 | -$112 | -0.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S DIXIE DRIVE DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $151 | $151 | 1.09% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | -$76 | -$76 | -0.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGOHAN/BRABENDER AGENCY | 3931 S DIXIE DRIVE DAYTON, OH 45439 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $23 | $23 | 1.11% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | -$12 | -$12 | -0.58% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMMUNITY INSURANCE COMPANY | 122 | $91K |
| Vision | COMMUNITY INSURANCE COMPANY | 299 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $40K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $14K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.