| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LANG FINANCIAL GROUP, INC.3 | 4225 MALSBARY ROAD SUITE 100 CINCINNATI, OH 45242 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 0.25% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELTY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $14K | — | $14K | 6.09% |
| OHIO AUTO DEALERS ASSN INS3 | TIM DORAN, EXEC VP 655 METRO PLACE SOUTH, STE 270 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $7K | $7K | 3.38% |
| LANG FINANCIAL GROUP, INC.3 | 4225 MALSBARY ROAD CINCINNATI, OH 45242 | DENTAL CARE PLUS, INC. | $4K | — | $4K | 3.58% |
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 | 444 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 241 | $1.3M |
| Dental | DENTAL CARE PLUS, INC. | 340 | $121K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY | 444 | $17K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 234 | $222K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 234 | $222K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 234 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 444 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.