| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS GROUP3 Filed as: PREFERRED BENEFITS AGENCY | PO BOX 25360 DELAWARE, OH 43015 | MEDICAL MUTUAL OF OHIO | $18K | $68 | $18K | 2.42% |
| OHIO AUTO DEALERS ASSN INS0 | 655 METRO PLACE SOUTH STE 270 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $2K | $2K | 4.40% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIFELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $647 | — | $647 | 1.16% |
| OHIO AUTO DEALERS ASSN INS0 | 655 METRO PLACE SOUTH STE 270 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $620 | $620 | 4.14% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIFELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $138 | — | $138 | 0.92% |
| PREFERRED BENEFITS GROUP Filed as: PREFERRED BENEFITS AGENCY | PO BOX 25360 DELAWARE, OH 43015 | UNITEDHEALTH CARE INSURANCE COMPANY | $1K | — | $1K | 10.48% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIFELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $198 | — | $198 | 2.13% |
| OHIO AUTO DEALERS ASSN INS0 | 655 METRO PLACE SOUTH STE 270 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $141 | $141 | 1.52% |
| OHIO AUTO DEALERS ASSN INS0 | 655 METRO PLACE SOUTH STE 270 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $80 | $80 | 1.34% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIFELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | — | — | $0 | 0.00% |
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 | 156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
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.