| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL CONNELLAN3 Filed as: MICHAEL CONNELLAN JR. | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | AETNA LIFE INSURANCE COMPANY | $10K | $18K | $28K | 2.89% |
| MICHAEL CONNELLAN3 | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 20.00% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE SERVIC | 2101 FLORENCE AVE CINCINNATI, OH 45206 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| MICHAEL CONNELLAN3 | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE SERVIC | 2101 FLORENCE AVE. CINCINNATI, OH 45206 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MICHAEL CONNELLAN3 | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 12.78% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE SERV | 2101 FLORENCE AVE CINCINNATI, OH 45206 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MICHAEL CONNELLAN3 | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| CORNERSTONE BROKER INS SERVICES3 Filed as: CORNERSTONE BROKER INSURANCE SERVIC | 2101 FLORENCE AVE. CINCINNATI, OH 45206 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $969 | — | $969 | 5.00% |
| MICHAEL CONNELLAN3 Filed as: MICHAEL CONNELLAN JR. | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 450113017 | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA, INC. | $13K | — | $13K | 72.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MICHAEL CONNELLAN JR NONE | Insurance agents and brokers Service code 22 | 5590 BROOKS RUN LIBERTY TOWNSHIP, OH 45011 | $31K |
| CBISA REACQUISTION CORP. NONE | Other services Service code 49 | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | $5K |
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 NONE | Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | -$364K |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 221 | $992K |
| Dental | AETNA LIFE INSURANCE COMPANY | 221 | $974K |
| Vision | AETNA LIFE INSURANCE COMPANY | 221 | $974K |
| Life insurance(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 110 | $122K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 31 | $19K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 69 | $26K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA, INC. | 29 | $18K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 110 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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.