| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFITS GROUP3 Filed as: PREFERRED BENEFITS SERVICES INC | P.O. BOX 868 DELAWARE, OH 43015 | UNITED HEALTHCARE INSURANCE COMPANY | $935 | $16K | $17K | 2.52% |
| OHIO AUTO DEALERS ASSN INS0 Filed as: OHIO AUTO DEALERS ASSOCIATION | 6515 LONGSHORE LOOP SUITE 320 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $2K | $2K | 3.50% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $902 | — | $902 | 1.47% |
| OHIO AUTO DEALERS ASSN INS0 Filed as: OHIO AUTO DEALERS ASSOCIATION | 6515 LONGSHORE LOOP SUITE 320 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $803 | $803 | 3.39% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $765 | — | $765 | 3.23% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $220 | — | $220 | 2.27% |
| OHIO AUTO DEALERS ASSN INS0 Filed as: OHIO AUTO DEALERS ASSOCIATION | 6515 LONGSHORE LOOP SUITE 320 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $116 | $116 | 1.20% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $197 | — | $197 | 3.93% |
| OHIO AUTO DEALERS ASSN INS0 Filed as: OHIO AUTO DEALER ASSN INS | 6515 LONGSHORE LOOP SUITE 320 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $88 | $88 | 1.76% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $488 | — | $488 | 26.68% |
| OHIO AUTO DEALERS ASSN INS0 Filed as: OHIO AUTO DEALERS ASSOCIATION | 6515 LONGSHORE LOOP SUITE 320 DUBLIN, OH 43017 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $39 | $39 | 2.13% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $108 | — | $108 | 17.20% |
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 | 97 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 97 | $684K |
| Short-term disability(2 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 86 | $67K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 25 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.